- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.89 / $761.30 / $1,008.76
| Facility | | $180.89 | $761.30 | $1,008.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.48 / $180.89 / $389.16
| Professional | | $66.48 | $180.89 | $389.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.56 / $378.51 / $1,013.52
| Facility | | $244.56 | $378.51 | $1,013.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.44 / $331.00 / $1,312.62
| Professional | | $155.44 | $331.00 | $1,312.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.86 / $751.98 / $1,314.65
| Facility | | $525.86 | $751.98 | $1,314.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.91 / $242.91 / $242.91
| Professional | | $242.91 | $242.91 | $242.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.64 / $378.32 / $753.03
| Facility | | $211.64 | $378.32 | $753.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.67 / $317.83 / $862.45
| Professional | | $175.67 | $317.83 | $862.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.48 / $477.48 / $561.74
| Professional | | $477.48 | $477.48 | $561.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.00 / $331.00 / $1,025.07
| Professional | | $331.00 | $331.00 | $1,025.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.94 / $1,572.25 / $1,572.25
| Facility | | $575.94 | $1,572.25 | $1,572.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.44 / $198.60 / $1,655.00
| Professional | | $155.44 | $198.60 | $1,655.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.89 / $331.00 / $397.20
| Facility | | $297.89 | $331.00 | $397.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.44 / $198.60 / $536.27
| Professional | | $155.44 | $198.60 | $536.27 |