- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.29 / $1,340.00 / $6,012.00
| Facility | | $124.29 | $1,340.00 | $6,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.43 / $104.18 / $194.45
| Professional | | $74.43 | $104.18 | $194.45 |
- 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
- $118.84 / $168.64 / $211.04
| Professional | | $118.84 | $168.64 | $211.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.24 / $138.24 / $138.24
| Facility | | $138.24 | $138.24 | $138.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.08 / $128.91 / $215.19
| Professional | | $88.08 | $128.91 | $215.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.80 / $192.84 / $244.93
| Professional | | $141.80 | $192.84 | $244.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.50 / $0.50 / $0.50
| Facility | | $0.50 | $0.50 | $0.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.96 / $1,819.00 / $7,799.00
| Facility | | $241.96 | $1,819.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.64 / $116.67 / $390.00
| Professional | | $75.64 | $116.67 | $390.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.60 / $122.60 / $250.70
| Professional | | $120.60 | $122.60 | $250.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.24 / $138.24 / $138.24
| Facility | | $138.24 | $138.24 | $138.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.89 / $129.61 / $217.91
| Professional | | $87.89 | $129.61 | $217.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.67 / $90.98 / $121.11
| Facility | | $79.67 | $90.98 | $121.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.67 / $113.15 / $124.48
| Professional | | $79.67 | $113.15 | $124.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.65 / $150.88 / $218.51
| Professional | | $111.65 | $150.88 | $218.51 |