- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.50 / $1,473.20 / $3,363.00
| Facility | | $254.50 | $1,473.20 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.10 / $209.70 / $494.52
| Professional | | $102.10 | $209.70 | $494.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $532.90 / $2,707.00
| Facility | | $55.00 | $532.90 | $2,707.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.69 / $236.61 / $691.55
| Professional | | $103.69 | $236.61 | $691.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.28 / $139.13 / $248.18
| Facility | | $108.28 | $139.13 | $248.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.09 / $225.26 / $335.67
| Professional | | $141.09 | $225.26 | $335.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.00 / $680.00 / $748.00
| Facility | | $680.00 | $680.00 | $748.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.87 / $245.53 / $485.51
| Professional | | $128.87 | $245.53 | $485.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.36 / $197.44 / $6,679.00
| Facility | | $92.36 | $197.44 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.97 / $216.04 / $317.08
| Professional | | $170.97 | $216.04 | $317.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.69 / $254.12 / $412.92
| Professional | | $133.69 | $254.12 | $412.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $532.90 / $2,733.00
| Facility | | $55.00 | $532.90 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.93 / $286.30 / $1,072.64
| Professional | | $165.93 | $286.30 | $1,072.64 |
- 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
- $151.25 / $227.65 / $502.31
| Professional | | $151.25 | $227.65 | $502.31 |