- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.05 / $2,663.12 / $3,693.00
| Facility | | $132.05 | $2,663.12 | $3,693.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.98 / $137.31 / $355.43
| Professional | | $71.98 | $137.31 | $355.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.10 / $411.20 / $2,713.00
| Facility | | $153.10 | $411.20 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.31 / $176.87 / $529.77
| Professional | | $76.31 | $176.87 | $529.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.23 / $104.30 / $190.06
| Facility | | $80.23 | $104.30 | $190.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.75 / $178.23 / $305.95
| Professional | | $107.75 | $178.23 | $305.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.97 / $172.30 / $328.34
| Professional | | $92.97 | $172.30 | $328.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.55 / $168.26 / $6,679.00
| Facility | | $81.55 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.65 / $171.26 / $236.40
| Professional | | $135.65 | $171.26 | $236.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.20 / $180.97 / $360.23
| Professional | | $85.20 | $180.97 | $360.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.88 / $278.88 / $278.88
| Facility | | $278.88 | $278.88 | $278.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.07 / $192.83 / $402.50
| Professional | | $168.07 | $192.83 | $402.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.74 / $244.91 / $883.12
| Professional | | $146.74 | $244.91 | $883.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.07 / $183.79 / $380.47
| Professional | | $134.07 | $183.79 | $380.47 |