- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.92 / $2,626.00 / $7,307.00
| Facility | | $260.92 | $2,626.00 | $7,307.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.47 / $319.38 / $585.91
| Professional | | $189.47 | $319.38 | $585.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,373.00 / $4,085.00 / $8,281.00
| Facility | | $2,373.00 | $4,085.00 | $8,281.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.61 / $291.14 / $710.94
| Professional | | $232.61 | $291.14 | $710.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.89 / $279.89 / $6,213.00
| Facility | | $279.89 | $279.89 | $6,213.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.89 / $279.89 / $506.68
| Professional | | $279.89 | $279.89 | $506.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.74 / $341.74 / $7,227.90
| Facility | | $341.74 | $341.74 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.91 / $425.27 / $948.23
| Professional | | $206.91 | $425.27 | $948.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $314.64 / $541.26
| Facility | | $225.00 | $314.64 | $541.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.69 / $490.05 / $717.67
| Professional | | $383.69 | $490.05 | $717.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.52 / $328.52 / $328.52
| Facility | | $328.52 | $328.52 | $328.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.82 / $422.87 / $656.29
| Professional | | $262.82 | $422.87 | $656.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.74 / $555.00 / $7,227.90
| Facility | | $341.74 | $555.00 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.47 / $456.83 / $925.47
| Professional | | $224.47 | $456.83 | $925.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,269.00 / $3,612.00 / $8,133.00
| Facility | | $1,269.00 | $3,612.00 | $8,133.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.56 / $380.73 / $889.95
| Professional | | $272.56 | $380.73 | $889.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.22 / $241.22 / $692.75
| Facility | | $241.22 | $241.22 | $692.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.82 / $474.26 / $709.69
| Professional | | $262.82 | $474.26 | $709.69 |