- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.94 / $3,623.00 / $8,247.00
| Facility | | $487.94 | $3,623.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.33 / $517.61 / $740.36
| Professional | | $322.33 | $517.61 | $740.36 |
- 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
- $341.69 / $354.58 / $354.58
| Professional | | $341.69 | $354.58 | $354.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.06 / $390.06 / $390.06
| Facility | | $390.06 | $390.06 | $390.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.80 / $574.76 / $959.72
| Professional | | $330.80 | $574.76 | $959.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,386.69 / $6,988.21 / $9,843.16
| Facility | | $3,386.69 | $6,988.21 | $9,843.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.72 / $346.71 / $2,652.00
| Professional | | $239.72 | $346.71 | $2,652.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $4,102.00 / $8,427.00
| Facility | | $768.00 | $4,102.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.33 / $526.84 / $1,560.79
| Professional | | $322.33 | $526.84 | $1,560.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.40 / $394.40 / $1,124.09
| Professional | | $394.40 | $394.40 | $1,124.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.06 / $390.06 / $390.06
| Facility | | $390.06 | $390.06 | $390.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.80 / $545.54 / $963.83
| Professional | | $330.80 | $545.54 | $963.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.12 / $336.12 / $596.27
| Facility | | $336.12 | $336.12 | $596.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.35 / $339.32 / $596.27
| Professional | | $324.35 | $339.32 | $596.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.43 / $500.51 / $815.19
| Professional | | $348.43 | $500.51 | $815.19 |