- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $2,070.00 / $7,197.00
| Facility | | $480.00 | $2,070.00 | $7,197.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.95 / $422.46 / $691.74
| Professional | | $363.95 | $422.46 | $691.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,292.00 / $5,951.00 / $9,100.00
| Facility | | $3,292.00 | $5,951.00 | $9,100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.83 / $464.73 / $772.09
| Professional | | $447.83 | $464.73 | $772.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.28 / $695.28 / $695.28
| Facility | | $695.28 | $695.28 | $695.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.36 / $501.77 / $829.49
| Professional | | $385.36 | $501.77 | $829.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.67 / $722.18 / $925.26
| Professional | | $535.67 | $722.18 | $925.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $951.22 / $1,611.20 / $4,436.52
| Facility | | $951.22 | $1,611.20 | $4,436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.06 / $460.86 / $492.38
| Professional | | $396.06 | $460.86 | $492.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.00 / $2,326.00 / $8,017.00
| Facility | | $641.00 | $2,326.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.19 / $470.49 / $1,234.00
| Professional | | $367.19 | $470.49 | $1,234.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.00 / $475.00 / $915.50
| Professional | | $475.00 | $475.00 | $915.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.28 / $695.28 / $695.28
| Facility | | $695.28 | $695.28 | $695.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.07 / $507.82 / $858.79
| Professional | | $387.07 | $507.82 | $858.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.42 / $400.06 / $434.52
| Facility | | $380.42 | $400.06 | $434.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.67 / $423.97 / $465.10
| Professional | | $389.67 | $423.97 | $465.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.00 / $1,305.00 / $3,742.00
| Facility | | $471.00 | $1,305.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.30 / $522.51 / $848.60
| Professional | | $381.30 | $522.51 | $848.60 |