- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $445.32 / $2,000.00 / $6,386.00
| Facility | | $445.32 | $2,000.00 | $6,386.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.32 / $234.65 / $543.91
| Professional | | $51.32 | $234.65 | $543.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.86 / $896.01 / $1,979.60
| Facility | | $522.86 | $896.01 | $1,979.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.27 / $307.20 / $577.95
| Professional | | $48.27 | $307.20 | $577.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.49 / $641.91 / $877.44
| Facility | | $505.49 | $641.91 | $877.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.29 / $453.65 / $453.65
| Facility | | $45.29 | $453.65 | $453.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.50 / $453.50 / $453.50
| Facility | | $453.50 | $453.50 | $453.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.67 / $127.33 / $604.64
| Professional | | $59.67 | $127.33 | $604.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $719.98
| Facility | | $55.00 | $55.00 | $719.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,462.69 / $2,839.59 / $3,326.40
| Professional | | $1,462.69 | $2,839.59 | $3,326.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.23 / $361.80 / $725.06
| Facility | | $55.23 | $361.80 | $725.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.44 / $419.86 / $687.04
| Professional | | $66.44 | $419.86 | $687.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $762.40 / $762.40 / $762.40
| Professional | | $762.40 | $762.40 | $762.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.23 / $362.61 / $742.16
| Facility | | $55.23 | $362.61 | $742.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.76 / $160.68 / $652.76
| Professional | | $59.76 | $160.68 | $652.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.00 / $1,651.00 / $4,090.00
| Facility | | $438.00 | $1,651.00 | $4,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.30 / $394.69 / $655.86
| Professional | | $272.30 | $394.69 | $655.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.76 / $362.61 / $518.35
| Professional | | $325.76 | $362.61 | $518.35 |