- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $564.78 / $3,066.00 / $8,017.00
| Facility | | $564.78 | $3,066.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.25 / $486.09 / $761.52
| Professional | | $330.25 | $486.09 | $761.52 |
- 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
- $538.34 / $558.66 / $990.34
| Professional | | $538.34 | $558.66 | $990.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.27 / $627.27 / $627.27
| Facility | | $627.27 | $627.27 | $627.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.90 / $534.47 / $945.58
| Professional | | $356.90 | $534.47 | $945.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $641.15 / $854.18 / $1,107.43
| Professional | | $641.15 | $854.18 | $1,107.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,596.63 / $8,204.96 / $8,827.45
| Facility | | $6,596.63 | $8,204.96 | $8,827.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.37 / $368.51 / $436.67
| Professional | | $348.37 | $368.51 | $436.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,839.00 / $8,017.00
| Facility | | $832.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.72 / $528.82 / $1,163.45
| Professional | | $334.72 | $528.82 | $1,163.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $590.60 / $590.60 / $1,174.50
| Professional | | $590.60 | $590.60 | $1,174.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.27 / $627.27 / $627.27
| Facility | | $627.27 | $627.27 | $627.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $366.51 / $552.86 / $966.03
| Professional | | $366.51 | $552.86 | $966.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.93 / $462.20 / $533.90
| Facility | | $352.93 | $462.20 | $533.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.84 / $513.60 / $559.63
| Professional | | $352.84 | $513.60 | $559.63 |
- 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
- $479.99 / $629.76 / $1,023.91
| Professional | | $479.99 | $629.76 | $1,023.91 |