- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.85 / $2,747.00 / $8,113.00
| Facility | | $431.85 | $2,747.00 | $8,113.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.39 / $449.31 / $779.29
| Professional | | $385.39 | $449.31 | $779.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.39 / $507.02 / $967.74
| Professional | | $423.39 | $507.02 | $967.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.13 / $707.13 / $707.13
| Facility | | $707.13 | $707.13 | $707.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.27 / $545.50 / $940.93
| Professional | | $408.27 | $545.50 | $940.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.01 / $679.82 / $867.10
| Professional | | $502.01 | $679.82 | $867.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $445.57 / $445.57 / $537.61
| Facility | | $445.57 | $445.57 | $537.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.97 / $455.27 / $464.17
| Professional | | $421.97 | $455.27 | $464.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,761.00 / $8,427.00
| Facility | | $657.00 | $4,761.00 | $8,427.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.93 / $540.39 / $1,039.59
| Professional | | $392.93 | $540.39 | $1,039.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $604.40 / $604.40 / $1,082.90
| Professional | | $604.40 | $604.40 | $1,082.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.13 / $707.13 / $707.13
| Facility | | $707.13 | $707.13 | $707.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.41 / $552.48 / $978.50
| Professional | | $408.41 | $552.48 | $978.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.68 / $412.69 / $550.74
| Facility | | $406.68 | $412.69 | $550.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.42 / $412.69 / $510.09
| Professional | | $400.42 | $412.69 | $510.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.69 / $559.88 / $919.02
| Professional | | $431.69 | $559.88 | $919.02 |