- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.51 / $1,273.00 / $2,900.00
| Facility | | $92.51 | $1,273.00 | $2,900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.22 / $94.34 / $248.90
| Professional | | $40.22 | $94.34 | $248.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $237.05 / $2,707.00
| Facility | | $55.00 | $237.05 | $2,707.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.30 / $163.40 / $820.40
| Professional | | $58.30 | $163.40 | $820.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.20 / $63.22 / $125.46
| Facility | | $49.20 | $63.22 | $125.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.17 / $82.24 / $251.09
| Professional | | $20.17 | $82.24 | $251.09 |
- 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
- $50.86 / $127.63 / $339.60
| Professional | | $50.86 | $127.63 | $339.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $49.30 / $168.26 / $6,679.00
| Facility | | $49.30 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.40 / $168.56 / $247.61
| Professional | | $133.40 | $168.56 | $247.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.70 / $140.49 / $311.19
| Professional | | $61.70 | $140.49 | $311.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.45 / $261.24 / $413.75
| Facility | | $198.45 | $261.24 | $413.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.98 / $185.50 / $415.08
| Professional | | $64.98 | $185.50 | $415.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $627.00 / $2,733.00
| Facility | | $55.00 | $627.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.23 / $267.24 / $820.40
| Professional | | $104.23 | $267.24 | $820.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.38 / $127.45 / $259.24
| Professional | | $74.38 | $127.45 | $259.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.00 / $1,078.00 / $2,733.00
| Facility | | $308.00 | $1,078.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.88 / $159.31 / $363.87
| Professional | | $84.88 | $159.31 | $363.87 |