- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.00 / $3,596.00 / $10,893.00
| Facility | | $732.00 | $3,596.00 | $10,893.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $590.54 / $662.05 / $988.23
| Professional | | $590.54 | $662.05 | $988.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.75 / $1,049.14 / $5,411.51
| Facility | | $626.75 | $1,049.14 | $5,411.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.19 / $744.53 / $1,037.29
| Professional | | $584.19 | $744.53 | $1,037.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.33 / $546.33 / $553.57
| Facility | | $546.33 | $546.33 | $553.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.86 / $2,024.00 / $4,619.00
| Facility | | $723.86 | $2,024.00 | $4,619.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $624.00 / $838.65 / $1,327.50
| Professional | | $624.00 | $838.65 | $1,327.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $5,115.53
| Facility | | $55.00 | $55.00 | $5,115.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,637.76 / $4,761.84 / $5,382.30
| Professional | | $4,637.76 | $4,761.84 | $5,382.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.52 / $783.94 / $1,447.38
| Facility | | $618.52 | $783.94 | $1,447.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $717.19 / $954.17 / $1,122.55
| Professional | | $717.19 | $954.17 | $1,122.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $966.90 / $1,618.40
| Professional | | $6.00 | $966.90 | $1,618.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.52 / $790.03 / $1,550.00
| Facility | | $618.52 | $790.03 | $1,550.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.11 / $894.53 / $1,597.75
| Professional | | $645.11 | $894.53 | $1,597.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $1,970.00 / $8,583.00
| Facility | | $385.00 | $1,970.00 | $8,583.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $513.21 / $685.63 / $1,091.17
| Professional | | $513.21 | $685.63 | $1,091.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $532.26 / $622.14 / $841.60
| Professional | | $532.26 | $622.14 | $841.60 |