- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $218.78 / $14,454.40
| Facility | | $117.49 | $218.78 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $120.23 / $229.09
| Professional | | $100.00 | $120.23 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,128.31 / $13,803.84
| Facility | | $5,011.87 | $8,128.31 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $199.53 / $524.81
| Professional | | $104.71 | $199.53 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $316.23 / $501.19
| Facility | | $269.15 | $316.23 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $245.47 / $446.68
| Professional | | $117.49 | $245.47 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $151.36 / $8,128.31
| Facility | | $102.33 | $151.36 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $229.09 / $371.54
| Professional | | $181.97 | $229.09 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $162.18 / $4,786.30
| Facility | | $107.15 | $162.18 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $204.17 / $2,884.03
| Professional | | $112.20 | $204.17 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $234.42 / $371.54
| Professional | | $128.82 | $234.42 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $2,238.72 / $2,238.72
| Facility | | $269.15 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $524.81 / $2,884.03
| Professional | | $114.82 | $524.81 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $389.05
| Professional | | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $467.74 / $524.81
| Professional | | $389.05 | $467.74 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $154.88 / $407.38
| Professional | | $107.15 | $154.88 | $407.38 |