- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.00 / $3,224.00 / $11,453.00
| Facility | | $748.00 | $3,224.00 | $11,453.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.32 / $581.29 / $967.88
| Professional | | $509.32 | $581.29 | $967.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,436.33 / $4,407.29 / $8,403.96
| Facility | | $2,436.33 | $4,407.29 | $8,403.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.96 / $672.06 / $915.80
| Professional | | $530.96 | $672.06 | $915.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $530.07 / $536.79
| Facility | | $80.00 | $530.07 | $536.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $654.32 / $654.32 / $654.32
| Facility | | $654.32 | $654.32 | $654.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $544.00 / $755.19 / $1,143.36
| Professional | | $544.00 | $755.19 | $1,143.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,159.48 / $11,500.00 / $26,542.00
| Facility | | $2,159.48 | $11,500.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,174.47 / $4,253.04 / $4,975.13
| Professional | | $4,174.47 | $4,253.04 | $4,975.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $527.17 / $673.35 / $1,077.98
| Facility | | $527.17 | $673.35 | $1,077.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $711.21 / $853.46 / $1,058.28
| Professional | | $711.21 | $853.46 | $1,058.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $738.42 / $766.90 / $953.50
| Professional | | $738.42 | $766.90 | $953.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.67 / $677.51 / $1,128.51
| Facility | | $532.67 | $677.51 | $1,128.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $554.69 / $774.73 / $1,185.94
| Professional | | $554.69 | $774.73 | $1,185.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,326.00 / $7,600.00
| Facility | | $1,154.00 | $3,326.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.55 / $590.05 / $951.77
| Professional | | $442.55 | $590.05 | $951.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.60 / $550.13 / $766.25
| Professional | | $485.60 | $550.13 | $766.25 |