- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.36 / $2,128.00 / $7,513.00
| Facility | | $86.36 | $2,128.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.14 / $67.93 / $104.45
| Professional | | $45.14 | $67.93 | $104.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,845.00 / $6,939.00 / $10,551.00
| Facility | | $1,845.00 | $6,939.00 | $10,551.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.20 / $61.34 / $97.11
| Professional | | $39.20 | $61.34 | $97.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.08 / $44.08 / $80.00
| Facility | | $44.08 | $44.08 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.87 / $82.87 / $82.87
| Facility | | $82.87 | $82.87 | $82.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.78 / $86.47 / $146.22
| Professional | | $54.78 | $86.47 | $146.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $230.47
| Facility | | $55.00 | $55.00 | $230.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.32 / $387.08 / $824.00
| Professional | | $354.32 | $387.08 | $824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.38 / $69.90 / $118.62
| Facility | | $46.38 | $69.90 | $118.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.14 / $86.04 / $122.85
| Professional | | $60.14 | $86.04 | $122.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.48 / $80.45 / $162.88
| Professional | | $48.48 | $80.45 | $162.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.38 / $70.50 / $121.47
| Facility | | $46.38 | $70.50 | $121.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.25 / $91.00 / $150.36
| Professional | | $55.25 | $91.00 | $150.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.00 / $950.00 / $2,405.00
| Facility | | $161.00 | $950.00 | $2,405.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.92 / $83.77 / $136.22
| Professional | | $60.92 | $83.77 | $136.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.25 / $66.43 / $92.52
| Professional | | $58.25 | $66.43 | $92.52 |