- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.93 / $375.25 / $2,412.86
| Facility | | $69.93 | $375.25 | $2,412.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.61 / $79.25 / $2,412.86
| Professional | | $60.61 | $79.25 | $2,412.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.00 / $724.87 / $1,849.98
| Facility | | $312.00 | $724.87 | $1,849.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.10 / $478.32 / $1,132.63
| Professional | | $150.10 | $478.32 | $1,132.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.60 / $271.31 / $1,058.21
| Facility | | $92.60 | $271.31 | $1,058.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.80 / $39.71 / $190.09
| Professional | | $27.80 | $39.71 | $190.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.47 / $643.91 / $1,256.14
| Facility | | $241.47 | $643.91 | $1,256.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.53 / $225.15 / $770.74
| Professional | | $50.53 | $225.15 | $770.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.41 / $375.25 / $506.59
| Professional | | $74.41 | $375.25 | $506.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.73 / $431.54 / $818.05
| Professional | | $337.73 | $431.54 | $818.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.94 / $1,782.44 / $1,782.44
| Facility | | $652.94 | $1,782.44 | $1,782.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,876.25 / $1,876.25 / $2,814.38
| Professional | | $1,876.25 | $1,876.25 | $2,814.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.31 / $450.31 / $450.31
| Professional | | $450.31 | $450.31 | $450.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.67 / $450.30 / $1,076.36
| Facility | | $110.67 | $450.30 | $1,076.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.37 / $412.78 / $750.50
| Professional | | $98.37 | $412.78 | $750.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,317.12 / $1,317.12 / $1,317.12
| Professional | | $1,317.12 | $1,317.12 | $1,317.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.90 / $126.50 / $375.25
| Professional | | $75.90 | $126.50 | $375.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.15 / $157.61 / $965.52
| Professional | | $39.15 | $157.61 | $965.52 |