- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.17 / $1,106.47 / $13,809.00
| Facility | | $514.17 | $1,106.47 | $13,809.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.65 / $388.91 / $807.78
| Professional | | $240.65 | $388.91 | $807.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.39 / $1,848.40 / $3,936.16
| Facility | | $596.39 | $1,848.40 | $3,936.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.28 / $840.97 / $3,189.60
| Professional | | $401.28 | $840.97 | $3,189.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.44 / $777.59 / $906.00
| Facility | | $511.44 | $777.59 | $906.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.68 / $589.16 / $1,148.89
| Professional | | $357.68 | $589.16 | $1,148.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.00 / $594.96 / $997.96
| Facility | | $383.00 | $594.96 | $997.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.56 / $636.73 / $1,033.29
| Professional | | $393.56 | $636.73 | $1,033.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.48 / $444.00 / $977.62
| Professional | | $45.48 | $444.00 | $977.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.71 / $740.43 / $874.35
| Facility | | $457.71 | $740.43 | $874.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.51 / $588.45 / $596.39
| Facility | | $236.51 | $588.45 | $596.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.28 / $669.63 / $1,093.20
| Professional | | $401.28 | $669.63 | $1,093.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.13 / $1,778.80 / $3,404.60
| Facility | | $1,154.13 | $1,778.80 | $3,404.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $386.23 / $600.14 / $1,010.07
| Professional | | $386.23 | $600.14 | $1,010.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.00 / $588.00 / $5,793.00
| Facility | | $140.00 | $588.00 | $5,793.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.73 / $641.69 / $1,254.17
| Professional | | $499.73 | $641.69 | $1,254.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.58 / $302.58 / $481.35
| Professional | | $302.58 | $302.58 | $481.35 |