- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.23 / $2,124.00 / $7,316.00
| Facility | | $383.23 | $2,124.00 | $7,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.01 / $233.54 / $464.85
| Professional | | $129.01 | $233.54 | $464.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.43 / $253.65 / $379.14
| Professional | | $119.43 | $253.65 | $379.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.37 / $110.37 / $297.98
| Facility | | $110.37 | $110.37 | $297.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.37 / $270.37 / $279.20
| Facility | | $270.37 | $270.37 | $279.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.74 / $281.49 / $459.78
| Professional | | $134.74 | $281.49 | $459.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $899.94
| Facility | | $55.00 | $55.00 | $899.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,080.11 / $2,430.53 / $2,951.46
| Professional | | $1,080.11 | $2,430.53 | $2,951.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.02 / $276.18 / $454.54
| Facility | | $130.02 | $276.18 | $454.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.83 / $308.85 / $477.31
| Professional | | $139.83 | $308.85 | $477.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.01 / $319.50 / $695.50
| Professional | | $127.01 | $319.50 | $695.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.02 / $277.74 / $473.73
| Facility | | $130.02 | $277.74 | $473.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.18 / $284.20 / $462.88
| Professional | | $137.18 | $284.20 | $462.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $2,045.00 / $4,509.00
| Facility | | $597.00 | $2,045.00 | $4,509.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $224.66 / $294.49 / $434.73
| Professional | | $224.66 | $294.49 | $434.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.63 / $268.37 / $381.15
| Professional | | $239.63 | $268.37 | $381.15 |