- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.40 / $1,426.00 / $6,012.00
| Facility | | $197.40 | $1,426.00 | $6,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.00 / $201.18 / $310.12
| Professional | | $122.00 | $201.18 | $310.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.67 / $226.92 / $226.92
| Professional | | $218.67 | $226.92 | $226.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.08 / $227.80 / $388.01
| Professional | | $142.08 | $227.80 | $388.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.13 / $349.44 / $352.93
| Professional | | $263.13 | $349.44 | $352.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $386.02 / $774.07 / $1,467.92
| Facility | | $386.02 | $774.07 | $1,467.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.00 / $1,741.00 / $7,197.00
| Facility | | $428.00 | $1,741.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.80 / $208.54 / $586.27
| Professional | | $129.80 | $208.54 | $586.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $206.20 / $573.50
| Professional | | $3.00 | $206.20 | $573.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.51 / $230.14 / $394.20
| Professional | | $145.51 | $230.14 | $394.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.72 / $130.47 / $213.19
| Facility | | $129.72 | $130.47 | $213.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.72 / $175.19 / $227.62
| Professional | | $129.72 | $175.19 | $227.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $577.00 / $3,742.00
| Facility | | $162.00 | $577.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.20 / $260.95 / $446.37
| Professional | | $186.20 | $260.95 | $446.37 |