- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $633.00 / $2,673.00 / $7,495.00
| Facility | | $633.00 | $2,673.00 | $7,495.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.71 / $374.16 / $571.75
| Professional | | $340.71 | $374.16 | $571.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,432.58 / $4,528.60 / $9,057.21
| Facility | | $2,432.58 | $4,528.60 | $9,057.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.76 / $389.95 / $555.32
| Professional | | $319.76 | $389.95 | $555.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.30 / $307.30 / $311.83
| Facility | | $307.30 | $307.30 | $311.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $935.02 / $1,240.44 / $2,213.00
| Facility | | $935.02 | $1,240.44 | $2,213.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.91 / $506.44 / $788.87
| Professional | | $369.91 | $506.44 | $788.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,482.70 / $11,500.00 / $16,394.00
| Facility | | $6,482.70 | $11,500.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,826.69 / $2,826.69 / $2,913.75
| Professional | | $2,826.69 | $2,826.69 | $2,913.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.25 / $483.49 / $836.63
| Facility | | $344.25 | $483.49 | $836.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.07 / $521.62 / $634.13
| Professional | | $392.07 | $521.62 | $634.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.76 / $459.20 / $672.79
| Professional | | $340.76 | $459.20 | $672.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.25 / $490.64 / $977.12
| Facility | | $344.25 | $490.64 | $977.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.02 / $530.70 / $901.73
| Professional | | $378.02 | $530.70 | $901.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,190.00 / $3,239.00 / $7,600.00
| Facility | | $1,190.00 | $3,239.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.38 / $408.89 / $644.91
| Professional | | $297.38 | $408.89 | $644.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.97 / $340.59 / $460.24
| Professional | | $290.97 | $340.59 | $460.24 |