- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,623.00 / $8,171.44
| Facility | | $954.00 | $3,623.00 | $8,171.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.19 / $568.91 / $828.08
| Professional | | $506.19 | $568.91 | $828.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $567.49 / $588.91 / $588.91
| Professional | | $567.49 | $588.91 | $588.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $643.16 / $643.16 / $643.16
| Facility | | $643.16 | $643.16 | $643.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.63 / $711.54 / $1,169.39
| Professional | | $546.63 | $711.54 | $1,169.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $673.54 / $911.85 / $1,163.39
| Professional | | $673.54 | $911.85 | $1,163.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,342.50 / $7,342.50 / $7,342.50
| Facility | | $7,342.50 | $7,342.50 | $7,342.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.28 / $752.96 / $769.35
| Professional | | $630.28 | $752.96 | $769.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $3,964.00 / $8,171.44
| Facility | | $1,013.00 | $3,964.00 | $8,171.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.65 / $679.09 / $2,843.00
| Professional | | $514.65 | $679.09 | $2,843.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $773.00 / $906.40 / $1,156.80
| Professional | | $773.00 | $906.40 | $1,156.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $643.16 / $643.16 / $643.16
| Facility | | $643.16 | $643.16 | $643.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $548.84 / $723.13 / $1,196.93
| Professional | | $548.84 | $723.13 | $1,196.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $551.58 / $551.58 / $856.81
| Facility | | $551.58 | $551.58 | $856.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.48 / $553.38 / $856.81
| Professional | | $535.48 | $553.38 | $856.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,368.00
| Facility | | $2,155.00 | $3,475.00 | $6,368.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $544.79 / $713.32 / $1,108.94
| Professional | | $544.79 | $713.32 | $1,108.94 |