- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.11 / $906.21 / $1,384.33
| Facility | | $268.11 | $906.21 | $1,384.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.37 / $268.11 / $2,128.33
| Professional | | $111.37 | $268.11 | $2,128.33 |
- 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
- $258.18 / $258.18 / $258.18
| Professional | | $258.18 | $258.18 | $258.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.12 / $489.03 / $1,098.56
| Facility | | $314.12 | $489.03 | $1,098.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.65 / $305.81 / $748.73
| Professional | | $85.65 | $305.81 | $748.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $196.95 / $433.61 / $628.90
| Professional | | $196.95 | $433.61 | $628.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.35 / $906.21 / $1,367.03
| Facility | | $281.35 | $906.21 | $1,367.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.53 / $281.35 / $1,367.03
| Professional | | $208.53 | $281.35 | $1,367.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.88 / $496.50 / $662.00
| Professional | | $489.88 | $496.50 | $662.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $322.08 / $550.67 / $1,098.56
| Facility | | $322.08 | $550.67 | $1,098.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.08 / $313.14 / $748.73
| Professional | | $100.08 | $313.14 | $748.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.61 / $331.00 / $331.00
| Facility | | $204.61 | $331.00 | $331.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.61 / $331.00 / $331.00
| Professional | | $204.61 | $331.00 | $331.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.77 / $198.60 / $463.40
| Professional | | $110.77 | $198.60 | $463.40 |