- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.00 / $2,172.00 / $7,513.00
| Facility | | $488.00 | $2,172.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.79 / $100.10 / $165.30
| Professional | | $87.79 | $100.10 | $165.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.56 / $96.73 / $107.29
| Professional | | $78.56 | $96.73 | $107.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.12 / $30.12 / $102.54
| Facility | | $30.12 | $30.12 | $102.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533.62 / $533.62 / $533.62
| Facility | | $533.62 | $533.62 | $533.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.07 / $149.79 / $223.67
| Professional | | $114.07 | $149.79 | $223.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $2,108.55
| Facility | | $55.00 | $55.00 | $2,108.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $813.45 / $840.30 / $969.45
| Professional | | $813.45 | $840.30 | $969.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.93 / $134.30 / $241.43
| Facility | | $101.93 | $134.30 | $241.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.76 / $163.31 / $192.13
| Professional | | $138.76 | $163.31 | $192.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.70 / $175.70 / $175.70
| Professional | | $175.70 | $175.70 | $175.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.93 / $136.50 / $249.18
| Facility | | $101.93 | $136.50 | $249.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $115.17 / $149.97 / $230.06
| Professional | | $115.17 | $149.97 | $230.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.00 / $1,529.00 / $3,400.00
| Facility | | $369.00 | $1,529.00 | $3,400.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.82 / $118.42 / $192.92
| Professional | | $83.82 | $118.42 | $192.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.10 / $103.31 / $141.91
| Professional | | $91.10 | $103.31 | $141.91 |