- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.72 / $3,554.15 / $7,799.00
| Facility | | $334.72 | $3,554.15 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.41 / $337.90 / $427.53
| Professional | | $305.41 | $337.90 | $427.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.32 / $342.78 / $342.78
| Professional | | $330.32 | $342.78 | $342.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.00 / $2,019.00 / $5,895.86
| Facility | | $491.00 | $2,019.00 | $5,895.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.62 / $448.11 / $737.14
| Professional | | $311.62 | $448.11 | $737.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.55 / $715.55 / $715.55
| Facility | | $715.55 | $715.55 | $715.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.34 / $494.48 / $637.25
| Professional | | $377.34 | $494.48 | $637.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.00 / $3,838.00 / $8,017.00
| Facility | | $768.00 | $3,838.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.41 / $383.03 / $1,843.50
| Professional | | $305.41 | $383.03 | $1,843.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.50 / $482.50 / $482.50
| Facility | | $482.50 | $482.50 | $482.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $573.40 / $789.00
| Professional | | $4.00 | $573.40 | $789.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.60 / $1,657.00 / $5,610.24
| Facility | | $378.60 | $1,657.00 | $5,610.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.62 / $446.47 / $762.98
| Professional | | $311.62 | $446.47 | $762.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.31 / $323.31 / $397.98
| Facility | | $323.31 | $323.31 | $397.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.27 / $327.26 / $397.98
| Professional | | $311.27 | $327.26 | $397.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,265.00 / $3,331.00 / $6,000.00
| Facility | | $1,265.00 | $3,331.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.70 / $409.27 / $673.38
| Professional | | $300.70 | $409.27 | $673.38 |