- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,747.00 / $8,017.00
| Facility | | $540.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.02 / $419.70 / $754.18
| Professional | | $281.02 | $419.70 | $754.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.35 / $6,182.00 / $17,094.48
| Facility | | $5,058.35 | $6,182.00 | $17,094.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.40 / $470.51 / $470.51
| Professional | | $453.40 | $470.51 | $470.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.53 / $530.53 / $530.53
| Facility | | $530.53 | $530.53 | $530.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.72 / $466.87 / $812.06
| Professional | | $311.72 | $466.87 | $812.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.58 / $719.60 / $933.74
| Professional | | $540.58 | $719.60 | $933.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.38 / $343.62 / $469.14
| Professional | | $312.38 | $343.62 | $469.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,077.00 / $8,017.00
| Facility | | $934.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.80 / $463.45 / $1,171.26
| Professional | | $298.80 | $463.45 | $1,171.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.90 / $487.90 / $997.00
| Professional | | $487.90 | $487.90 | $997.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.53 / $530.53 / $530.53
| Facility | | $530.53 | $530.53 | $530.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.94 / $469.94 / $822.96
| Professional | | $311.94 | $469.94 | $822.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.83 / $405.93 / $472.10
| Facility | | $298.83 | $405.93 | $472.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.20 / $434.05 / $472.87
| Professional | | $298.20 | $434.05 | $472.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.31 / $548.80 / $900.98
| Professional | | $404.31 | $548.80 | $900.98 |