- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $4,265.80 / $8,317.64
| Facility | | $831.76 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $426.58 / $891.25
| Professional | | $302.00 | $426.58 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $457.09 / $758.58
| Professional | | $436.52 | $457.09 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $549.54
| Facility | | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $446.68 / $776.25
| Professional | | $309.03 | $446.68 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $724.44 / $912.01
| Professional | | $537.03 | $724.44 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $549.54 / $851.14
| Professional | | $354.81 | $549.54 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,801.89 / $8,317.64
| Facility | | $831.76 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $512.86 / $1,202.26
| Professional | | $323.59 | $512.86 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $933.25
| Facility | | $331.13 | $331.13 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $416.87 / $933.25
| Professional | | $363.08 | $416.87 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $371.54 / $467.74
| Facility | | $275.42 | $371.54 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $416.87 / $467.74
| Professional | | $275.42 | $416.87 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,365.16 / $10,715.19
| Facility | | $2,344.23 | $4,365.16 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $426.58 / $707.95
| Professional | | $288.40 | $426.58 | $707.95 |