- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.38 / $2,769.52 / $18,711.00
| Facility | | $236.38 | $2,769.52 | $18,711.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.38 / $166.52 / $350.45
| Professional | | $116.38 | $166.52 | $350.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,300.00 / $1,300.00
| Facility | | $55.00 | $1,300.00 | $1,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.48 / $294.87 / $1,870.00
| Professional | | $176.48 | $294.87 | $1,870.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.59 / $233.38 / $385.28
| Professional | | $144.59 | $233.38 | $385.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.65 / $273.07 / $353.50
| Facility | | $128.65 | $273.07 | $353.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.65 / $279.77 / $350.71
| Professional | | $128.65 | $279.77 | $350.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.72 / $213.38 / $355.75
| Professional | | $35.72 | $213.38 | $355.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.10 / $250.87 / $262.64
| Facility | | $210.10 | $250.87 | $262.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.05 / $173.05 / $174.57
| Facility | | $173.05 | $173.05 | $174.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.44 / $299.05 / $363.66
| Professional | | $197.44 | $299.05 | $363.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.48 / $250.59 / $338.26
| Professional | | $176.48 | $250.59 | $338.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $414.00 / $666.00 / $6,216.00
| Facility | | $414.00 | $666.00 | $6,216.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.94 / $249.60 / $388.56
| Professional | | $138.94 | $249.60 | $388.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.69 / $133.69 / $133.69
| Professional | | $133.69 | $133.69 | $133.69 |