- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.36 / $467.99 / $2,217.96
| Facility | | $236.36 | $467.99 | $2,217.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.07 / $228.31 / $408.11
| Professional | | $191.07 | $228.31 | $408.11 |
- 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
- $214.01 / $222.09 / $433.90
| Professional | | $214.01 | $222.09 | $433.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.83 / $594.79 / $1,213.41
| Facility | | $240.83 | $594.79 | $1,213.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.62 / $262.47 / $436.99
| Professional | | $171.62 | $262.47 | $436.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.19 / $313.19 / $349.24
| Professional | | $313.19 | $313.19 | $349.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.97 / $1,289.17 / $2,254.85
| Facility | | $1,248.97 | $1,289.17 | $2,254.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.36 / $432.54 / $1,025.46
| Facility | | $236.36 | $432.54 | $1,025.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.44 / $236.36 / $441.99
| Professional | | $202.44 | $236.36 | $441.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.83 / $578.42 / $1,213.41
| Facility | | $240.83 | $578.42 | $1,213.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.49 / $271.79 / $440.27
| Professional | | $179.49 | $271.79 | $440.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.63 / $219.63 / $235.00
| Facility | | $219.63 | $219.63 | $235.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.68 / $219.63 / $239.75
| Professional | | $215.68 | $219.63 | $239.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.55 / $268.63 / $441.56
| Professional | | $198.55 | $268.63 | $441.56 |