- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.00 / $2,594.00 / $7,542.00
| Facility | | $714.00 | $2,594.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $670.47 / $740.99 / $1,191.15
| Professional | | $670.47 | $740.99 | $1,191.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.34 / $1,209.79 / $4,110.35
| Facility | | $727.34 | $1,209.79 | $4,110.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $715.03 / $911.27 / $1,254.41
| Professional | | $715.03 | $911.27 | $1,254.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.45 / $727.45 / $751.46
| Facility | | $727.45 | $727.45 | $751.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $889.21 / $2,024.00 / $4,619.00
| Facility | | $889.21 | $2,024.00 | $4,619.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $721.65 / $989.62 / $1,515.00
| Professional | | $721.65 | $989.62 | $1,515.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $7,082.80
| Facility | | $55.00 | $55.00 | $7,082.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,544.72 / $5,666.96 / $6,768.68
| Professional | | $5,544.72 | $5,666.96 | $6,768.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $713.76 / $923.53 / $1,586.23
| Facility | | $713.76 | $923.53 | $1,586.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $880.87 / $1,171.93 / $1,424.70
| Professional | | $880.87 | $1,171.93 | $1,424.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.00 / $1,184.90 / $1,750.70
| Professional | | $7.00 | $1,184.90 | $1,750.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.09 / $935.47 / $1,630.58
| Facility | | $714.09 | $935.47 | $1,630.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $747.87 / $1,032.78 / $1,821.66
| Professional | | $747.87 | $1,032.78 | $1,821.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $2,045.00 / $4,480.00
| Facility | | $593.00 | $2,045.00 | $4,480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $598.79 / $792.62 / $1,238.89
| Professional | | $598.79 | $792.62 | $1,238.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $653.73 / $759.91 / $1,025.77
| Professional | | $653.73 | $759.91 | $1,025.77 |