- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.39 / $1,803.00 / $3,363.00
| Facility | | $200.39 | $1,803.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.31 / $193.98 / $297.39
| Professional | | $114.31 | $193.98 | $297.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.23 / $953.00 / $2,733.00
| Facility | | $202.23 | $953.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.81 / $263.91 / $1,211.35
| Professional | | $100.81 | $263.91 | $1,211.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.77 / $141.40 / $267.42
| Facility | | $108.77 | $141.40 | $267.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.37 / $178.37 / $339.95
| Professional | | $178.37 | $178.37 | $339.95 |
- 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
- $144.18 / $282.73 / $544.61
| Professional | | $144.18 | $282.73 | $544.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.90 / $198.32 / $6,679.00
| Facility | | $92.90 | $198.32 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.89 / $247.53 / $442.57
| Professional | | $195.89 | $247.53 | $442.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.62 / $247.68 / $459.23
| Professional | | $114.62 | $247.68 | $459.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.31 / $353.31 / $353.31
| Facility | | $353.31 | $353.31 | $353.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.66 / $278.66 / $278.66
| Professional | | $278.66 | $278.66 | $278.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,078.00 / $3,445.00
| Facility | | $55.00 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.02 / $520.66 / $1,211.35
| Professional | | $192.02 | $520.66 | $1,211.35 |
- 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
- $188.51 / $270.70 / $659.39
| Professional | | $188.51 | $270.70 | $659.39 |