- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.81 / $1,941.00 / $6,143.86
| Facility | | $93.81 | $1,941.00 | $6,143.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.81 / $170.11 / $506.00
| Professional | | $91.81 | $170.11 | $506.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,759.00 / $4,718.00 / $9,381.00
| Facility | | $1,759.00 | $4,718.00 | $9,381.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.94 / $180.39 / $591.40
| Professional | | $125.94 | $180.39 | $591.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $1,975.17
| Facility | | $66.00 | $100.00 | $1,975.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.12 / $124.71 / $304.01
| Professional | | $88.12 | $124.71 | $304.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,115.08 / $2,499.65 / $5,888.95
| Facility | | $2,115.08 | $2,499.65 | $5,888.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.74 / $131.80 / $398.64
| Professional | | $101.74 | $131.80 | $398.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.14 / $117.85 / $2,347.40
| Professional | | $107.14 | $117.85 | $2,347.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.79 / $128.08 / $227.17
| Professional | | $97.79 | $128.08 | $227.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $575.40 / $9,496.40
| Facility | | $55.00 | $575.40 | $9,496.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,500.00 / $1,500.00 / $1,500.00
| Professional | | $1,500.00 | $1,500.00 | $1,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.46 / $133.93 / $224.97
| Facility | | $102.46 | $133.93 | $224.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.74 / $133.16 / $292.11
| Professional | | $101.74 | $133.16 | $292.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.39 / $325.39 / $325.39
| Professional | | $325.39 | $325.39 | $325.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.26 / $118.61 / $118.61
| Professional | | $86.26 | $118.61 | $118.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,523.00 / $7,384.00 / $16,148.00
| Facility | | $3,523.00 | $7,384.00 | $16,148.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.62 / $122.26 / $327.60
| Professional | | $86.62 | $122.26 | $327.60 |