- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.51 / $301.94 / $8,170.61
| Facility | | $162.51 | $301.94 | $8,170.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.65 / $149.88 / $230.46
| Professional | | $129.65 | $149.88 | $230.46 |
- 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
- $159.21 / $165.22 / $282.19
| Professional | | $159.21 | $165.22 | $282.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.03 / $296.00 / $7,546.28
| Facility | | $128.03 | $296.00 | $7,546.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.57 / $252.03 / $606.91
| Professional | | $124.57 | $252.03 | $606.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.51 / $243.24 / $451.93
| Professional | | $192.51 | $243.24 | $451.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,648.32 / $6,648.32 / $6,648.32
| Facility | | $6,648.32 | $6,648.32 | $6,648.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.51 / $301.94 / $7,781.43
| Facility | | $162.51 | $301.94 | $7,781.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.05 / $162.51 / $383.71
| Professional | | $133.05 | $162.51 | $383.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.80 / $677.30 / $789.90
| Professional | | $292.80 | $677.30 | $789.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.76 / $284.52 / $7,570.74
| Facility | | $123.76 | $284.52 | $7,570.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.91 / $237.52 / $602.97
| Professional | | $124.91 | $237.52 | $602.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.00 / $151.00 / $488.17
| Facility | | $151.00 | $151.00 | $488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.35 / $151.00 / $488.17
| Professional | | $148.35 | $151.00 | $488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.85 / $226.04 / $451.00
| Professional | | $159.85 | $226.04 | $451.00 |