- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.30 / $3,235.18 / $8,698.48
| Facility | | $199.30 | $3,235.18 | $8,698.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.99 / $402.16 / $777.97
| Professional | | $151.99 | $402.16 | $777.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,393.00 / $4,120.00 / $8,836.00
| Facility | | $2,393.00 | $4,120.00 | $8,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.45 / $371.63 / $989.35
| Professional | | $279.45 | $371.63 | $989.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.06 / $1,716.00 / $6,213.00
| Facility | | $198.06 | $1,716.00 | $6,213.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.06 / $198.06 / $560.91
| Professional | | $198.06 | $198.06 | $560.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.35 / $239.35 / $4,612.43
| Facility | | $239.35 | $239.35 | $4,612.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.13 / $474.58 / $1,244.84
| Professional | | $159.13 | $474.58 | $1,244.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.00 / $238.50 / $380.60
| Facility | | $159.00 | $238.50 | $380.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.69 / $475.40 / $711.46
| Professional | | $366.69 | $475.40 | $711.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.45 / $435.34 / $679.20
| Professional | | $305.45 | $435.34 | $679.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.20 / $2,767.05 / $6,062.07
| Facility | | $851.20 | $2,767.05 | $6,062.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.35 / $597.00 / $8,498.00
| Facility | | $239.35 | $597.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.54 / $508.36 / $1,244.84
| Professional | | $175.54 | $508.36 | $1,244.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,031.00 / $4,840.00 / $9,202.00
| Facility | | $2,031.00 | $4,840.00 | $9,202.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.92 / $472.96 / $1,213.40
| Professional | | $314.92 | $472.96 | $1,213.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.50 / $181.50 / $491.72
| Facility | | $181.50 | $181.50 | $491.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.64 / $444.07 / $753.90
| Professional | | $259.64 | $444.07 | $753.90 |