- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.66 / $821.79 / $1,201.53
| Facility | | $230.66 | $821.79 | $1,201.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.17 / $230.66 / $352.71
| Professional | | $218.17 | $230.66 | $352.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.66 / $343.06 / $939.30
| Facility | | $221.66 | $343.06 | $939.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.00 / $315.00 / $1,189.69
| Professional | | $180.00 | $315.00 | $1,189.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.60 / $721.10 / $2,760.00
| Facility | | $476.60 | $721.10 | $2,760.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.51 / $329.51 / $329.51
| Professional | | $329.51 | $329.51 | $329.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.00 / $366.60 / $682.50
| Facility | | $195.00 | $366.60 | $682.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.16 / $316.55 / $782.16
| Professional | | $158.16 | $316.55 | $782.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,472.00 / $9,239.00
| Facility | | $83.43 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.67 / $432.67 / $509.02
| Professional | | $432.67 | $432.67 | $509.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.00 / $300.00 / $942.40
| Professional | | $300.00 | $300.00 | $942.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.91 / $311.91 / $311.91
| Facility | | $311.91 | $311.91 | $311.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.00 / $1,425.00 / $1,425.00
| Facility | | $522.00 | $1,425.00 | $1,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.00 / $197.71 / $1,500.00
| Professional | | $180.00 | $197.71 | $1,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.00 / $197.71 / $620.04
| Professional | | $180.00 | $197.71 | $620.04 |