- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,301.00 / $5,056.10 / $8,451.00
| Facility | | $1,301.00 | $5,056.10 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.60 / $450.00 / $770.25
| Professional | | $259.60 | $450.00 | $770.25 |
- 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
- $55,249.45 / $64,999.35 / $64,999.35
| Professional | | $55,249.45 | $64,999.35 | $64,999.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.00 / $800.00 / $2,269.00
| Facility | | $495.00 | $800.00 | $2,269.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55,249.45 / $55,249.45 / $55,249.45
| Professional | | $55,249.45 | $55,249.45 | $55,249.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,546.28 / $2,546.28 / $3,804.54
| Facility | | $2,546.28 | $2,546.28 | $3,804.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.00 / $655.50 / $677.00
| Professional | | $533.00 | $655.50 | $677.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $5,056.10 / $8,451.00
| Facility | | $1,013.00 | $5,056.10 | $8,451.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.60 / $630.16 / $5,457.00
| Professional | | $259.60 | $630.16 | $5,457.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.00 / $800.00 / $2,269.00
| Facility | | $495.00 | $800.00 | $2,269.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,102.00 / $1,102.00 / $1,102.00
| Professional | | $1,102.00 | $1,102.00 | $1,102.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.00 / $1,728.00 / $4,300.00
| Facility | | $550.00 | $1,728.00 | $4,300.00 |