- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.39 / $2,747.00 / $8,048.63
| Facility | | $532.39 | $2,747.00 | $8,048.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.68 / $457.04 / $944.81
| Professional | | $333.68 | $457.04 | $944.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $494.46 / $513.12 / $513.12
| Professional | | $494.46 | $513.12 | $513.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $620.91 / $620.91 / $620.91
| Facility | | $620.91 | $620.91 | $620.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.45 / $500.73 / $859.99
| Professional | | $354.45 | $500.73 | $859.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $592.47 / $800.46 / $1,023.36
| Professional | | $592.47 | $800.46 | $1,023.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,262.62 / $4,371.38 / $7,273.55
| Facility | | $2,262.62 | $4,371.38 | $7,273.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.00 / $2,675.00 / $8,048.63
| Facility | | $574.00 | $2,675.00 | $8,048.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.68 / $505.50 / $1,195.17
| Professional | | $333.68 | $505.50 | $1,195.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.20 / $427.20 / $1,059.50
| Professional | | $427.20 | $427.20 | $1,059.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $620.91 / $620.91 / $620.91
| Facility | | $620.91 | $620.91 | $620.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.11 / $509.47 / $891.13
| Professional | | $367.11 | $509.47 | $891.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.95 / $356.77 / $489.56
| Facility | | $348.95 | $356.77 | $489.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.95 / $427.53 / $524.74
| Professional | | $348.95 | $427.53 | $524.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,214.00 / $2,752.00 / $5,505.63
| Facility | | $1,214.00 | $2,752.00 | $5,505.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.83 / $564.73 / $927.81
| Professional | | $415.83 | $564.73 | $927.81 |