- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $2,673.00 / $7,495.00
| Facility | | $657.00 | $2,673.00 | $7,495.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $443.61 / $510.59 / $632.00
| Professional | | $443.61 | $510.59 | $632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,440.08 / $4,362.30 / $8,175.28
| Facility | | $2,440.08 | $4,362.30 | $8,175.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $414.91 / $525.17 / $715.65
| Professional | | $414.91 | $525.17 | $715.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $414.85 / $414.85 / $414.85
| Facility | | $414.85 | $414.85 | $414.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,280.46 / $2,280.46 / $2,280.46
| Facility | | $2,280.46 | $2,280.46 | $2,280.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.34 / $614.89 / $947.49
| Professional | | $477.34 | $614.89 | $947.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,011.04 / $16,394.00 / $16,394.00
| Facility | | $9,011.04 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,184.72 / $3,260.16 / $3,898.35
| Professional | | $3,184.72 | $3,260.16 | $3,898.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.94 / $614.05 / $1,010.30
| Facility | | $472.94 | $614.05 | $1,010.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $573.14 / $661.32 / $793.58
| Professional | | $573.14 | $661.32 | $793.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $526.29 / $822.09 / $1,656.41
| Professional | | $526.29 | $822.09 | $1,656.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.94 / $634.36 / $1,259.14
| Facility | | $472.94 | $634.36 | $1,259.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.73 / $634.57 / $984.64
| Professional | | $481.73 | $634.57 | $984.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,425.00 / $10,600.00
| Facility | | $1,634.00 | $4,425.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.69 / $533.84 / $841.34
| Professional | | $407.69 | $533.84 | $841.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.28 / $430.99 / $588.86
| Professional | | $376.28 | $430.99 | $588.86 |