- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $772.65 / $3,213.00 / $11,453.00
| Facility | | $772.65 | $3,213.00 | $11,453.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $649.90 / $745.27 / $1,234.19
| Professional | | $649.90 | $745.27 | $1,234.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,618.78 / $4,379.92 / $8,568.21
| Facility | | $2,618.78 | $4,379.92 | $8,568.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $675.60 / $858.36 / $1,173.29
| Professional | | $675.60 | $858.36 | $1,173.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $676.64 / $686.82
| Facility | | $80.00 | $676.64 | $686.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $838.09 / $838.09 / $838.09
| Facility | | $838.09 | $838.09 | $838.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $715.31 / $966.35 / $1,448.11
| Professional | | $715.31 | $966.35 | $1,448.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $8,957.00
| Facility | | $55.00 | $55.00 | $8,957.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,347.44 / $5,449.12 / $6,370.50
| Professional | | $5,347.44 | $5,449.12 | $6,370.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $698.09 / $866.78 / $1,378.38
| Facility | | $698.09 | $866.78 | $1,378.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $910.96 / $1,093.16 / $1,355.51
| Professional | | $910.96 | $1,093.16 | $1,355.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $780.40 / $1,230.20 / $1,289.16
| Professional | | $780.40 | $1,230.20 | $1,289.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.99 / $866.78 / $1,393.04
| Facility | | $700.99 | $866.78 | $1,393.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.54 / $988.53 / $1,499.52
| Professional | | $724.54 | $988.53 | $1,499.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,093.00 / $6,000.00 / $13,134.00
| Facility | | $2,093.00 | $6,000.00 | $13,134.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $570.30 / $771.66 / $1,216.08
| Professional | | $570.30 | $771.66 | $1,216.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.98 / $705.25 / $981.18
| Professional | | $621.98 | $705.25 | $981.18 |