- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $459.84 / $1,481.12 / $2,262.55
| Facility | | $459.84 | $1,481.12 | $2,262.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.76 / $427.38 / $459.84
| Professional | | $85.76 | $427.38 | $459.84 |
- 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
- $421.97 / $421.97 / $421.97
| Professional | | $421.97 | $421.97 | $421.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.57 / $703.28 / $1,795.07
| Facility | | $355.57 | $703.28 | $1,795.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.57 / $621.57 / $776.96
| Professional | | $621.57 | $621.57 | $776.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.86 / $319.18 / $732.50
| Professional | | $248.86 | $319.18 | $732.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.49 / $1,089.49 / $1,089.49
| Facility | | $1,089.49 | $1,089.49 | $1,089.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.22 / $1,471.06 / $2,262.55
| Facility | | $557.22 | $1,471.06 | $2,262.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.82 / $438.20 / $2,234.29
| Professional | | $340.82 | $438.20 | $2,234.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.03 / $720.40 / $1,795.07
| Facility | | $378.03 | $720.40 | $1,795.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.57 / $621.57 / $776.96
| Professional | | $621.57 | $621.57 | $776.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.99 / $540.99 / $595.09
| Facility | | $540.99 | $540.99 | $595.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.07 / $540.99 / $595.09
| Professional | | $476.07 | $540.99 | $595.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.22 / $346.23 / $919.68
| Professional | | $227.22 | $346.23 | $919.68 |