- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.81 / $2,496.00 / $7,316.00
| Facility | | $205.81 | $2,496.00 | $7,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.04 / $140.44 / $200.01
| Professional | | $34.04 | $140.44 | $200.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $561.15 / $1,002.51 / $2,143.73
| Facility | | $561.15 | $1,002.51 | $2,143.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.32 / $118.43 / $208.58
| Professional | | $30.32 | $118.43 | $208.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.36 / $29.36 / $29.36
| Facility | | $29.36 | $29.36 | $29.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.01 / $477.01 / $477.01
| Facility | | $477.01 | $477.01 | $477.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.27 / $82.26 / $259.80
| Professional | | $39.27 | $82.26 | $259.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.45 / $16,394.00 / $16,394.00
| Facility | | $230.45 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $687.00 / $1,048.33 / $1,171.50
| Professional | | $687.00 | $1,048.33 | $1,171.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.77 / $143.27 / $280.83
| Facility | | $36.77 | $143.27 | $280.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.63 / $56.04 / $236.04
| Professional | | $41.63 | $56.04 | $236.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.00 / $125.98 / $266.70
| Professional | | $32.00 | $125.98 | $266.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.77 / $148.93 / $350.02
| Facility | | $36.77 | $148.93 | $350.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.04 / $108.16 / $277.12
| Professional | | $40.04 | $108.16 | $277.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.00 / $1,527.00 / $5,925.00
| Facility | | $369.00 | $1,527.00 | $5,925.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.94 / $177.53 / $280.38
| Professional | | $131.94 | $177.53 | $280.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.12 / $128.63 / $183.09
| Professional | | $115.12 | $128.63 | $183.09 |