- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.05 / $234.58 / $394.66
| Facility | | $156.05 | $234.58 | $394.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.80 / $315.64 / $653.14
| Professional | | $169.80 | $315.64 | $653.14 |
- 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
- $216.57 / $269.42 / $588.55
| Professional | | $216.57 | $269.42 | $588.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.26 / $1,716.00 / $6,213.00
| Facility | | $183.26 | $1,716.00 | $6,213.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.26 / $183.26 / $353.71
| Professional | | $183.26 | $183.26 | $353.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.82 / $135.82 / $223.23
| Professional | | $135.82 | $135.82 | $223.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.77 / $217.04 / $332.00
| Facility | | $134.77 | $217.04 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.05 / $323.94 / $646.82
| Professional | | $248.05 | $323.94 | $646.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.25 / $287.66 / $438.91
| Professional | | $195.25 | $287.66 | $438.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,176.86 / $2,693.68 / $6,548.38
| Facility | | $1,176.86 | $2,693.68 | $6,548.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $597.00 / $74,999.25
| Facility | | $555.00 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.23 / $355.40 / $805.08
| Professional | | $223.23 | $355.40 | $805.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.59 / $306.38 / $781.63
| Professional | | $197.59 | $306.38 | $781.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.28 / $172.28 / $464.51
| Facility | | $172.28 | $172.28 | $464.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.28 / $320.26 / $483.34
| Professional | | $172.28 | $320.26 | $483.34 |