- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.12 / $1,426.00 / $7,594.56
| Facility | | $265.12 | $1,426.00 | $7,594.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.12 / $372.36 / $660.70
| Professional | | $170.12 | $372.36 | $660.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.55 / $468.88 / $468.88
| Professional | | $398.55 | $468.88 | $468.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.77 / $313.77 / $313.77
| Facility | | $313.77 | $313.77 | $313.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.36 / $369.27 / $725.33
| Professional | | $184.36 | $369.27 | $725.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.16 / $737.73 / $950.29
| Professional | | $550.16 | $737.73 | $950.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,908.63 / $2,878.30 / $8,875.18
| Facility | | $1,908.63 | $2,878.30 | $8,875.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.32 / $197.26 / $472.70
| Professional | | $179.32 | $197.26 | $472.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.45 / $1,633.00 / $7,799.00
| Facility | | $274.45 | $1,633.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.09 / $393.51 / $975.93
| Professional | | $172.09 | $393.51 | $975.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.40 / $359.40 / $1,056.40
| Professional | | $359.40 | $359.40 | $1,056.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.77 / $313.77 / $313.77
| Facility | | $313.77 | $313.77 | $313.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.96 / $377.53 / $727.64
| Professional | | $187.96 | $377.53 | $727.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.76 / $313.35 / $466.00
| Facility | | $181.76 | $313.35 | $466.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.76 / $401.79 / $506.48
| Professional | | $181.76 | $401.79 | $506.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.03 / $514.74 / $853.45
| Professional | | $360.03 | $514.74 | $853.45 |