- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.52 / $442.20 / $5,449.00
| Facility | | $264.52 | $442.20 | $5,449.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.52 / $301.77 / $540.24
| Professional | | $264.52 | $301.77 | $540.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,015.30 / $2,015.30 / $2,044.70
| Facility | | $2,015.30 | $2,015.30 | $2,044.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.29 / $386.78 / $721.64
| Professional | | $257.29 | $386.78 | $721.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $2,710.28
| Facility | | $395.75 | $395.75 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.17 / $382.61 / $718.52
| Professional | | $240.17 | $382.61 | $718.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.52 / $318.00 / $551.97
| Facility | | $264.52 | $318.00 | $551.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.10 / $367.00 / $416.00
| Professional | | $307.10 | $367.00 | $416.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.25 / $449.45 / $562.61
| Professional | | $394.25 | $449.45 | $562.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,711.00 / $7,162.00 / $10,397.00
| Facility | | $1,711.00 | $7,162.00 | $10,397.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.83 / $344.19 / $724.41
| Professional | | $223.83 | $344.19 | $724.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,294.72 / $1,466.75 / $12,000.00
| Facility | | $1,294.72 | $1,466.75 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,032.48 / $2,318.80 / $2,757.30
| Professional | | $2,032.48 | $2,318.80 | $2,757.30 |