- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.83 / $3,519.18 / $7,799.00
| Facility | | $501.83 | $3,519.18 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.33 / $430.92 / $743.34
| Professional | | $289.33 | $430.92 | $743.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.08 / $308.08 / $308.08
| Professional | | $308.08 | $308.08 | $308.08 |
- 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
- $469.89 / $487.62 / $883.76
| Professional | | $469.89 | $487.62 | $883.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.53 / $535.53 / $535.53
| Facility | | $535.53 | $535.53 | $535.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.24 / $477.85 / $828.83
| Professional | | $314.24 | $477.85 | $828.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $560.48 / $746.05 / $968.11
| Professional | | $560.48 | $746.05 | $968.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,771.02 / $6,281.80 / $11,938.27
| Facility | | $2,771.02 | $6,281.80 | $11,938.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.54 / $317.06 / $483.44
| Professional | | $299.54 | $317.06 | $483.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.00 / $3,745.00 / $8,017.00
| Facility | | $655.00 | $3,745.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.56 / $462.61 / $1,033.79
| Professional | | $294.56 | $462.61 | $1,033.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578.20 / $578.20 / $1,073.90
| Professional | | $578.20 | $578.20 | $1,073.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.53 / $535.53 / $535.53
| Facility | | $535.53 | $535.53 | $535.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.27 / $487.60 / $865.45
| Professional | | $316.27 | $487.60 | $865.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.98 / $441.63 / $490.82
| Facility | | $305.98 | $441.63 | $490.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.69 / $456.08 / $497.51
| Professional | | $305.69 | $456.08 | $497.51 |
- 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
- $432.65 / $584.09 / $955.97
| Professional | | $432.65 | $584.09 | $955.97 |