- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $3,630.78 / $8,511.38
| Facility | | $213.80 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $204.17 / $524.81
| Professional | | $151.36 | $204.17 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $5,248.07 / $57,543.99
| Facility | | $5,011.87 | $5,248.07 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $416.87
| Professional | | $234.42 | $234.42 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $229.09 / $398.11
| Professional | | $169.82 | $229.09 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $346.74 / $380.19
| Professional | | $269.15 | $346.74 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $269.15 / $371.54
| Professional | | $169.82 | $269.15 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $7,413.10
| Facility | | $6,760.83 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,570.40 / $8,317.64
| Facility | | $467.74 | $2,570.40 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $251.19 / $575.44
| Professional | | $158.49 | $251.19 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $489.78
| Facility | | $251.19 | $251.19 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $331.13 / $467.74
| Professional | | $218.78 | $331.13 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $229.09 / $407.38
| Facility | | $169.82 | $229.09 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $229.09 / $407.38
| Professional | | $169.82 | $229.09 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $10,000.00
| Facility | | $1,348.96 | $3,548.13 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $213.80 / $363.08
| Professional | | $162.18 | $213.80 | $363.08 |