- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,663.12 / $2,763.49 / $4,806.64
| Facility | | $2,663.12 | $2,763.49 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.52 / $2,311.62 / $2,763.49
| Professional | | $434.52 | $2,311.62 | $2,763.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,225.40 / $7,231.00
| Facility | | $55.00 | $1,225.40 | $7,231.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.48 / $737.48 / $16,500.00
| Professional | | $468.48 | $737.48 | $16,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $680.00 / $748.00
| Facility | | $50.00 | $680.00 | $748.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $558.85 / $964.77 / $1,748.55
| Professional | | $558.85 | $964.77 | $1,748.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $983.30 / $8,090.00
| Facility | | $300.00 | $983.30 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $547.45 / $688.31 / $1,047.21
| Professional | | $547.45 | $688.31 | $1,047.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.29 / $1,177.33 / $1,457.77
| Professional | | $601.29 | $1,177.33 | $1,457.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,845.00 / $16,500.00
| Facility | | $55.00 | $1,845.00 | $16,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.35 / $782.68 / $16,500.00
| Professional | | $474.35 | $782.68 | $16,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $2,446.00 / $4,050.00
| Facility | | $789.00 | $2,446.00 | $4,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.35 / $700.33 / $1,785.04
| Professional | | $474.35 | $700.33 | $1,785.04 |