- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.38 / $1,294.00 / $3,103.52
| Facility | | $116.38 | $1,294.00 | $3,103.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.29 / $118.21 / $219.28
| Professional | | $80.29 | $118.21 | $219.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.97 / $389.60 / $2,733.00
| Facility | | $88.97 | $389.60 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.66 / $186.80 / $572.88
| Professional | | $88.66 | $186.80 | $572.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.43 / $118.77 / $212.03
| Facility | | $92.43 | $118.77 | $212.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.94 / $191.95 / $513.80
| Professional | | $117.94 | $191.95 | $513.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.59 / $177.54 / $310.70
| Professional | | $106.59 | $177.54 | $310.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $168.54 / $6,679.00
| Facility | | $83.43 | $168.54 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.44 / $166.48 / $229.42
| Professional | | $137.44 | $166.48 | $229.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.44 / $217.87 / $331.80
| Professional | | $102.44 | $217.87 | $331.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.59 / $208.59 / $569.50
| Professional | | $208.59 | $208.59 | $569.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $966.90 / $3,445.00
| Facility | | $55.00 | $966.90 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.96 / $229.16 / $856.80
| Professional | | $127.96 | $229.16 | $856.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.12 / $182.49 / $391.43
| Professional | | $117.12 | $182.49 | $391.43 |