- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.00 / $2,673.00 / $7,495.00
| Facility | | $661.00 | $2,673.00 | $7,495.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.38 / $524.41 / $680.93
| Professional | | $445.38 | $524.41 | $680.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,734.91 / $7,275.80 / $14,454.58
| Facility | | $3,734.91 | $7,275.80 | $14,454.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.23 / $524.32 / $768.74
| Professional | | $394.23 | $524.32 | $768.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.79 / $428.79 / $428.79
| Facility | | $428.79 | $428.79 | $428.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,187.68 / $4,187.68 / $4,187.68
| Facility | | $4,187.68 | $4,187.68 | $4,187.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $455.95 / $601.02 / $940.60
| Professional | | $455.95 | $601.02 | $940.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $16,394.00 / $16,547.20
| Facility | | $11,500.00 | $16,394.00 | $16,547.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,429.36 / $3,553.68 / $4,012.13
| Professional | | $3,429.36 | $3,553.68 | $4,012.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.10 / $564.15 / $1,038.50
| Facility | | $442.10 | $564.15 | $1,038.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.33 / $707.72 / $832.61
| Professional | | $601.33 | $707.72 | $832.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.80 / $509.80 / $509.80
| Professional | | $509.80 | $509.80 | $509.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.10 / $584.88 / $1,206.00
| Facility | | $442.10 | $584.88 | $1,206.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.15 / $608.34 / $1,003.83
| Professional | | $456.15 | $608.34 | $1,003.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,284.00 / $4,100.00 / $8,326.00
| Facility | | $1,284.00 | $4,100.00 | $8,326.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.53 / $502.28 / $792.68
| Professional | | $357.53 | $502.28 | $792.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $394.77 / $444.72 / $626.01
| Professional | | $394.77 | $444.72 | $626.01 |