- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.92 / $4,011.00 / $18,711.00
| Facility | | $335.92 | $4,011.00 | $18,711.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.12 / $242.97 / $483.90
| Professional | | $170.12 | $242.97 | $483.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $3,930.50 / $3,930.50
| Facility | | $55.00 | $3,930.50 | $3,930.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.94 / $432.21 / $1,567.05
| Professional | | $249.94 | $432.21 | $1,567.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.27 / $327.52 / $555.00
| Professional | | $195.27 | $327.52 | $555.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.32 / $380.97 / $509.49
| Facility | | $177.32 | $380.97 | $509.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.32 / $385.92 / $500.78
| Professional | | $177.32 | $385.92 | $500.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.77 / $320.14 / $536.05
| Professional | | $53.77 | $320.14 | $536.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.44 / $360.71 / $369.17
| Facility | | $272.44 | $360.71 | $369.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.07 / $245.07 / $251.81
| Facility | | $245.07 | $245.07 | $251.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.48 / $426.20 / $516.45
| Professional | | $280.48 | $426.20 | $516.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $249.94 / $358.41 / $487.91
| Professional | | $249.94 | $358.41 | $487.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $414.00 / $666.00 / $6,216.00
| Facility | | $414.00 | $666.00 | $6,216.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.21 / $334.18 / $527.15
| Professional | | $210.21 | $334.18 | $527.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.27 / $194.27 / $194.27
| Professional | | $194.27 | $194.27 | $194.27 |