- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.00 / $2,244.00 / $7,513.00
| Facility | | $521.00 | $2,244.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.07 / $350.74 / $570.33
| Professional | | $307.07 | $350.74 | $570.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,107.84 / $4,215.67 / $8,212.35
| Facility | | $2,107.84 | $4,215.67 | $8,212.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.54 / $394.40 / $553.20
| Professional | | $318.54 | $394.40 | $553.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $329.76 / $331.68
| Facility | | $80.00 | $329.76 | $331.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $396.91 / $396.91 / $396.91
| Facility | | $396.91 | $396.91 | $396.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.74 / $451.49 / $695.57
| Professional | | $336.74 | $451.49 | $695.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,307.96 / $11,500.00 / $12,000.00
| Facility | | $1,307.96 | $11,500.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,019.50 / $3,711.01 / $3,833.47
| Professional | | $3,019.50 | $3,711.01 | $3,833.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.89 / $402.70 / $648.37
| Facility | | $325.89 | $402.70 | $648.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.43 / $517.71 / $641.96
| Professional | | $431.43 | $517.71 | $641.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.32 / $626.57 / $1,312.69
| Professional | | $404.32 | $626.57 | $1,312.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.36 / $409.51 / $698.18
| Facility | | $327.36 | $409.51 | $698.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.89 / $465.41 / $709.67
| Professional | | $343.89 | $465.41 | $709.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.00 / $2,064.00 / $4,509.00
| Facility | | $600.00 | $2,064.00 | $4,509.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.89 / $357.47 / $557.67
| Professional | | $266.89 | $357.47 | $557.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.57 / $332.68 / $465.32
| Professional | | $294.57 | $332.68 | $465.32 |