- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.00 / $3,219.00 / $11,391.00
| Facility | | $714.00 | $3,219.00 | $11,391.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.70 / $286.88 / $450.41
| Professional | | $262.70 | $286.88 | $450.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,767.31 / $4,881.66 / $10,043.50
| Facility | | $2,767.31 | $4,881.66 | $10,043.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.16 / $318.00 / $460.47
| Professional | | $251.16 | $318.00 | $460.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.16 / $250.16 / $257.64
| Facility | | $250.16 | $250.16 | $257.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,024.00 / $3,841.34 / $4,552.00
| Facility | | $2,024.00 | $3,841.34 | $4,552.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.38 / $400.00 / $637.28
| Professional | | $287.38 | $400.00 | $637.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $17,986.75 / $26,542.00
| Facility | | $11,500.00 | $17,986.75 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,073.09 / $2,141.50 / $2,275.05
| Professional | | $2,073.09 | $2,141.50 | $2,275.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.67 / $391.55 / $658.73
| Facility | | $266.67 | $391.55 | $658.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.26 / $408.79 / $496.95
| Professional | | $307.26 | $408.79 | $496.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $541.60 / $663.50
| Professional | | $4.00 | $541.60 | $663.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.86 / $399.52 / $696.81
| Facility | | $266.86 | $399.52 | $696.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.64 / $412.05 / $701.39
| Professional | | $294.64 | $412.05 | $701.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,608.00 / $7,719.00 / $16,982.00
| Facility | | $2,608.00 | $7,719.00 | $16,982.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.53 / $321.60 / $520.90
| Professional | | $239.53 | $321.60 | $520.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.03 / $266.86 / $359.84
| Professional | | $228.03 | $266.86 | $359.84 |