- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.00 / $3,950.89 / $7,799.00
| Facility | | $655.00 | $3,950.89 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.77 / $432.98 / $501.74
| Professional | | $396.77 | $432.98 | $501.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.03 / $433.51 / $710.73
| Professional | | $391.03 | $433.51 | $710.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.20 / $529.02 / $924.23
| Professional | | $406.20 | $529.02 | $924.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.82 / $476.24 / $478.05
| Professional | | $371.82 | $476.24 | $478.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,287.86 / $1,766.00 / $8,760.21
| Facility | | $1,287.86 | $1,766.00 | $8,760.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $4,068.00 / $8,017.00
| Facility | | $832.00 | $4,068.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.30 / $467.30 / $1,749.00
| Professional | | $407.30 | $467.30 | $1,749.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.40 / $502.40 / $524.90
| Professional | | $502.40 | $502.40 | $524.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.58 / $552.58 / $552.58
| Facility | | $552.58 | $552.58 | $552.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $428.37 / $536.96 / $990.21
| Professional | | $428.37 | $536.96 | $990.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.47 / $408.47 / $1,006.97
| Facility | | $408.47 | $408.47 | $1,006.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.47 / $424.69 / $1,006.97
| Professional | | $408.47 | $424.69 | $1,006.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $650.00 / $4,300.00
| Facility | | $144.00 | $650.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.60 / $448.05 / $778.10
| Professional | | $303.60 | $448.05 | $778.10 |