- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $2,181.00 / $7,513.00
| Facility | | $500.00 | $2,181.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.03 / $380.62 / $558.54
| Professional | | $341.03 | $380.62 | $558.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,476.51 / $4,525.47 / $9,021.19
| Facility | | $2,476.51 | $4,525.47 | $9,021.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.04 / $431.79 / $601.41
| Professional | | $341.04 | $431.79 | $601.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.38 / $361.38 / $367.65
| Facility | | $361.38 | $361.38 | $367.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,322.00 / $2,584.00 / $11,682.00
| Facility | | $1,322.00 | $2,584.00 | $11,682.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.70 / $480.18 / $746.12
| Professional | | $329.70 | $480.18 | $746.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,100.00 / $11,102.00
| Facility | | $55.00 | $2,100.00 | $11,102.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,645.44 / $2,705.52 / $3,207.68
| Professional | | $2,645.44 | $2,705.52 | $3,207.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.21 / $417.77 / $802.22
| Facility | | $339.21 | $417.77 | $802.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.49 / $556.77 / $676.85
| Professional | | $418.49 | $556.77 | $676.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.50 / $666.30 / $1,019.43
| Professional | | $330.50 | $666.30 | $1,019.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.35 / $427.83 / $822.71
| Facility | | $343.35 | $427.83 | $822.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.50 / $500.53 / $925.11
| Professional | | $350.50 | $500.53 | $925.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,200.00 / $10,600.00
| Facility | | $1,634.00 | $4,200.00 | $10,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.37 / $393.89 / $604.22
| Professional | | $286.37 | $393.89 | $604.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.58 / $361.49 / $488.88
| Professional | | $310.58 | $361.49 | $488.88 |