- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.34 / $659.00 / $2,747.00
| Facility | | $77.34 | $659.00 | $2,747.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.35 / $77.34 / $178.65
| Professional | | $22.35 | $77.34 | $178.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.84 / $355.54 / $2,713.00
| Facility | | $81.84 | $355.54 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.61 / $103.83 / $371.54
| Professional | | $38.61 | $103.83 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.01 / $176.70 / $237.82
| Facility | | $51.01 | $176.70 | $237.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.04 / $122.21 / $253.79
| Professional | | $54.04 | $122.21 | $253.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.73 / $302.56 / $341.96
| Facility | | $267.73 | $302.56 | $341.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.86 / $89.13 / $270.31
| Professional | | $30.86 | $89.13 | $270.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.41 / $83.43 / $6,679.00
| Facility | | $41.41 | $83.43 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.15 / $103.11 / $166.68
| Professional | | $60.15 | $103.11 | $166.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.01 / $110.72 / $276.66
| Professional | | $43.01 | $110.72 | $276.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.16 / $307.45 / $737.95
| Facility | | $174.16 | $307.45 | $737.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.93 / $151.50 / $154.47
| Professional | | $92.93 | $151.50 | $154.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.20 / $1,078.00 / $3,445.00
| Facility | | $241.20 | $1,078.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.00 / $113.09 / $651.16
| Professional | | $69.00 | $113.09 | $651.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.45 / $243.05 / $497.06
| Facility | | $17.45 | $243.05 | $497.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.98 / $103.83 / $203.79
| Professional | | $59.98 | $103.83 | $203.79 |