- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.60 / $2,240.00 / $7,629.00
| Facility | | $372.60 | $2,240.00 | $7,629.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.18 / $294.85 / $452.27
| Professional | | $147.18 | $294.85 | $452.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.15 / $341.57 / $341.57
| Professional | | $329.15 | $341.57 | $341.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.83 / $266.83 / $266.83
| Facility | | $266.83 | $266.83 | $266.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.84 / $312.70 / $625.75
| Professional | | $164.84 | $312.70 | $625.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.47 / $508.03 / $680.60
| Professional | | $393.47 | $508.03 | $680.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.80 / $176.80 / $176.80
| Professional | | $176.80 | $176.80 | $176.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,371.00 / $8,017.00
| Facility | | $617.00 | $2,371.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.03 / $321.44 / $916.60
| Professional | | $148.03 | $321.44 | $916.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.85 / $341.30 / $668.10
| Professional | | $150.85 | $341.30 | $668.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.33 / $266.83 / $266.83
| Facility | | $175.33 | $266.83 | $266.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.05 / $312.70 / $615.29
| Professional | | $167.05 | $312.70 | $615.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.58 / $240.27 / $450.93
| Facility | | $153.58 | $240.27 | $450.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.58 / $333.68 / $364.10
| Professional | | $153.58 | $333.68 | $364.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $674.00 / $3,742.00
| Facility | | $144.00 | $674.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.36 / $434.90 / $684.87
| Professional | | $335.36 | $434.90 | $684.87 |