- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.00 / $2,496.00 / $7,542.00
| Facility | | $546.00 | $2,496.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.67 / $446.32 / $703.91
| Professional | | $343.67 | $446.32 | $703.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.58 / $489.81 / $1,811.03
| Facility | | $282.58 | $489.81 | $1,811.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.50 / $440.73 / $706.46
| Professional | | $331.50 | $440.73 | $706.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $328.39 / $329.25
| Facility | | $80.00 | $328.39 | $329.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.22 / $612.22 / $612.22
| Facility | | $612.22 | $612.22 | $612.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $395.28 / $580.79 / $896.17
| Professional | | $395.28 | $580.79 | $896.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $2,551.32
| Facility | | $55.00 | $55.00 | $2,551.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,085.00 / $3,356.56 / $3,868.20
| Professional | | $3,085.00 | $3,356.56 | $3,868.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $374.07 / $531.38 / $894.68
| Facility | | $374.07 | $531.38 | $894.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $463.40 / $606.54 / $808.72
| Professional | | $463.40 | $606.54 | $808.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $556.00 / $556.00 / $556.00
| Professional | | $556.00 | $556.00 | $556.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $374.16 / $532.13 / $915.78
| Facility | | $374.16 | $532.13 | $915.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.99 / $618.63 / $945.36
| Professional | | $408.99 | $618.63 | $945.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,451.00 / $7,600.00
| Facility | | $1,154.00 | $3,451.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.21 / $533.16 / $830.27
| Professional | | $401.21 | $533.16 | $830.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.46 / $433.14 / $608.80
| Professional | | $383.46 | $433.14 | $608.80 |