- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.98 / $1,886.00 / $3,625.00
| Facility | | $176.98 | $1,886.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.59 / $205.30 / $463.26
| Professional | | $79.59 | $205.30 | $463.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.38 / $623.42 / $2,713.00
| Facility | | $150.38 | $623.42 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.89 / $222.55 / $676.19
| Professional | | $72.89 | $222.55 | $676.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.86 / $102.52 / $201.49
| Facility | | $78.86 | $102.52 | $201.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.50 / $205.88 / $406.98
| Professional | | $117.50 | $205.88 | $406.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $214.73 / $214.73 / $308.82
| Professional | 50 | $214.73 | $214.73 | $308.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.44 / $174.44 / $174.44
| Facility | | $174.44 | $174.44 | $174.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.21 / $226.16 / $501.33
| Professional | | $98.21 | $226.16 | $501.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.09 / $168.26 / $6,679.00
| Facility | | $80.09 | $168.26 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.17 / $256.14 / $356.19
| Professional | | $202.17 | $256.14 | $356.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.56 / $221.59 / $577.90
| Professional | | $83.56 | $221.59 | $577.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,559.85 / $1,559.85 / $3,135.07
| Facility | | $1,559.85 | $1,559.85 | $3,135.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.32 / $267.85 / $304.83
| Professional | | $105.32 | $267.85 | $304.83 |
- 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
- $194.80 / $326.39 / $1,523.16
| Professional | | $194.80 | $326.39 | $1,523.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $1,790.00 / $2,733.00
| Facility | | $500.00 | $1,790.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.15 / $282.45 / $561.66
| Professional | | $182.15 | $282.45 | $561.66 |