- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $1,978.00 / $8,017.00
| Facility | | $480.00 | $1,978.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.89 / $204.78 / $426.17
| Professional | | $126.89 | $204.78 | $426.17 |
- 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
- $423.11 / $439.08 / $439.08
| Professional | | $423.11 | $439.08 | $439.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.87 / $238.87 / $238.87
| Facility | | $238.87 | $238.87 | $238.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.71 / $189.81 / $996.25
| Professional | | $172.71 | $189.81 | $996.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.86 / $269.22 / $329.67
| Professional | | $190.86 | $269.22 | $329.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,535.32 / $1,583.65 / $3,654.62
| Facility | | $1,535.32 | $1,583.65 | $3,654.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.00 / $1,819.00 / $8,017.00
| Facility | | $536.00 | $1,819.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.19 / $217.63 / $1,023.00
| Professional | | $142.19 | $217.63 | $1,023.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $458.10 / $458.10 / $474.70
| Professional | | $458.10 | $458.10 | $474.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.87 / $238.87 / $238.87
| Facility | | $238.87 | $238.87 | $238.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.71 / $189.81 / $996.25
| Professional | | $172.71 | $189.81 | $996.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.98 / $228.98 / $353.40
| Facility | | $228.98 | $228.98 | $353.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.36 / $233.56 / $353.40
| Professional | | $150.36 | $233.56 | $353.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.87 / $466.03 / $798.92
| Professional | | $261.87 | $466.03 | $798.92 |