- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,096.48 / $7,943.28
| Facility | | $588.84 | $1,096.48 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $426.58 / $954.99
| Professional | | $275.42 | $426.58 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $741.31
| Facility | | $741.31 | $741.31 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $645.65 / $1,174.90
| Professional | | $371.54 | $645.65 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $741.31 / $1,071.52
| Professional | | $524.81 | $741.31 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $575.44 / $977.24
| Facility | | $338.84 | $575.44 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $691.83 / $1,023.29
| Professional | | $478.63 | $691.83 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $870.96 / $891.25
| Facility | | $602.56 | $870.96 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $575.44 / $933.25
| Facility | | $338.84 | $575.44 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $691.83 / $1,096.48
| Professional | | $79.43 | $691.83 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,232.93 / $12,302.69
| Facility | | $7,762.47 | $10,232.93 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $812.83 / $1,122.02
| Professional | | $537.03 | $812.83 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,000.00 / $14,125.38
| Facility | | $1,995.26 | $10,000.00 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $676.08 / $1,096.48
| Professional | | $426.58 | $676.08 | $1,096.48 |