- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.00 / $2,221.00 / $7,316.00
| Facility | | $488.00 | $2,221.00 | $7,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.05 / $351.53 / $425.78
| Professional | | $303.05 | $351.53 | $425.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.12 / $4,505.85 / $8,892.35
| Facility | | $2,503.12 | $4,505.85 | $8,892.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.26 / $367.77 / $511.86
| Professional | | $290.26 | $367.77 | $511.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.19 / $307.19 / $307.19
| Facility | | $307.19 | $307.19 | $307.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,804.61 / $2,804.61 / $2,804.61
| Facility | | $2,804.61 | $2,804.61 | $2,804.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.07 / $414.05 / $605.27
| Professional | | $322.07 | $414.05 | $605.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,082.10 / $12,000.00 / $12,000.00
| Facility | | $11,082.10 | $12,000.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,255.76 / $2,303.19 / $2,738.48
| Professional | | $2,255.76 | $2,303.19 | $2,738.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.31 / $390.51 / $679.99
| Facility | | $312.31 | $390.51 | $679.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.69 / $465.80 / $558.95
| Professional | | $403.69 | $465.80 | $558.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.20 / $361.20 / $361.20
| Professional | | $361.20 | $361.20 | $361.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.31 / $398.07 / $809.19
| Facility | | $312.31 | $398.07 | $809.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.94 / $421.39 / $645.28
| Professional | | $325.94 | $421.39 | $645.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,345.00 / $10,600.00
| Facility | | $1,634.00 | $4,345.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.52 / $323.69 / $536.05
| Professional | | $242.52 | $323.69 | $536.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.02 / $300.39 / $416.96
| Professional | | $265.02 | $300.39 | $416.96 |