- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,516.00 / $5,845.00 / $10,686.00
| Facility | | $1,516.00 | $5,845.00 | $10,686.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.78 / $287.80 / $323.07
| Professional | | $180.78 | $287.80 | $323.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,691.00 / $3,333.00 / $4,636.00
| Facility | | $1,691.00 | $3,333.00 | $4,636.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.46 / $166.19 / $312.56
| Professional | | $140.46 | $166.19 | $312.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,499.62 / $37,499.62 / $37,499.62
| Facility | | $37,499.62 | $37,499.62 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.14 / $284.14 / $284.14
| Facility | | $284.14 | $284.14 | $284.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,181.82 / $1,181.82 / $1,181.82
| Professional | | $1,181.82 | $1,181.82 | $1,181.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.16 / $311.85 / $503.76
| Professional | | $233.16 | $311.85 | $503.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.14 / $284.14 / $74,999.25
| Facility | | $284.14 | $284.14 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,181.82 / $1,181.82 / $1,181.82
| Professional | | $1,181.82 | $1,181.82 | $1,181.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,749.00 / $4,194.00 / $9,300.00
| Facility | | $1,749.00 | $4,194.00 | $9,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.16 / $326.50 / $765.54
| Professional | | $215.16 | $326.50 | $765.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.13 / $240.13 / $251.09
| Facility | | $240.13 | $240.13 | $251.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.13 / $251.09 / $503.76
| Professional | | $240.13 | $251.09 | $503.76 |