- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $2,131.00 / $7,513.00
| Facility | | $425.00 | $2,131.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.83 / $292.91 / $491.71
| Professional | | $246.83 | $292.91 | $491.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,380.71 / $4,243.05 / $8,431.35
| Facility | | $2,380.71 | $4,243.05 | $8,431.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.49 / $322.98 / $467.64
| Professional | | $256.49 | $322.98 | $467.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $267.93 / $267.93
| Facility | | $80.00 | $267.93 | $267.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.46 / $466.46 / $466.46
| Facility | | $466.46 | $466.46 | $466.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.68 / $362.57 / $558.63
| Professional | | $272.68 | $362.57 | $558.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,315.04 / $11,500.00 / $12,000.00
| Facility | | $1,315.04 | $11,500.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,032.48 / $2,356.80 / $2,757.30
| Professional | | $2,032.48 | $2,356.80 | $2,757.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.86 / $318.95 / $529.32
| Facility | | $243.86 | $318.95 | $529.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.53 / $441.53 / $567.67
| Professional | | $359.53 | $441.53 | $567.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.92 / $543.91 / $1,088.45
| Professional | | $319.92 | $543.91 | $1,088.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.18 / $323.75 / $565.63
| Facility | | $245.18 | $323.75 | $565.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.76 / $386.44 / $601.70
| Professional | | $278.76 | $386.44 | $601.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,239.00 / $7,600.00
| Facility | | $1,154.00 | $3,239.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.37 / $308.52 / $479.49
| Professional | | $227.37 | $308.52 | $479.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.17 / $302.47 / $426.18
| Professional | | $269.17 | $302.47 | $426.18 |