- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $2,221.00 / $7,316.00
| Facility | | $500.00 | $2,221.00 | $7,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.11 / $387.30 / $539.41
| Professional | | $353.11 | $387.30 | $539.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,610.90 / $4,256.14 / $8,451.91
| Facility | | $1,610.90 | $4,256.14 | $8,451.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.02 / $391.07 / $733.97
| Professional | | $284.02 | $391.07 | $733.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $320.45 / $320.45 / $320.45
| Facility | | $320.45 | $320.45 | $320.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,376.10 / $2,376.10 / $2,376.10
| Facility | | $2,376.10 | $2,376.10 | $2,376.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $379.84 / $497.10 / $759.06
| Professional | | $379.84 | $497.10 | $759.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,388.90 / $12,000.00 / $12,000.00
| Facility | | $9,388.90 | $12,000.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,666.32 / $2,725.60 / $3,033.45
| Professional | | $2,666.32 | $2,725.60 | $3,033.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.96 / $481.08 / $820.57
| Facility | | $354.96 | $481.08 | $820.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.71 / $543.39 / $639.29
| Professional | | $461.71 | $543.39 | $639.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $561.60 / $561.60 / $561.60
| Professional | | $561.60 | $561.60 | $561.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.34 / $490.37 / $926.75
| Facility | | $355.34 | $490.37 | $926.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.04 / $509.70 / $777.63
| Professional | | $381.04 | $509.70 | $777.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.00 / $1,529.00 / $3,287.00
| Facility | | $369.00 | $1,529.00 | $3,287.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.33 / $424.38 / $655.86
| Professional | | $307.33 | $424.38 | $655.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.12 / $348.01 / $479.20
| Professional | | $303.12 | $348.01 | $479.20 |