- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.00 / $2,594.00 / $7,495.00
| Facility | | $714.00 | $2,594.00 | $7,495.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $626.37 / $705.56 / $959.76
| Professional | | $626.37 | $705.56 | $959.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,033.67 / $4,588.18 / $8,240.61
| Facility | | $2,033.67 | $4,588.18 | $8,240.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $617.14 / $781.15 / $1,088.31
| Professional | | $617.14 | $781.15 | $1,088.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.89 / $3,362.73 / $3,362.73
| Facility | | $607.89 | $3,362.73 | $3,362.73 |
- 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
- $700.02 / $900.13 / $1,422.30
| Professional | | $700.02 | $900.13 | $1,422.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $9,388.90
| Facility | | $55.00 | $55.00 | $9,388.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,968.39 / $5,074.88 / $5,685.15
| Professional | | $4,968.39 | $5,074.88 | $5,685.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.37 / $776.28 / $1,489.09
| Facility | | $626.37 | $776.28 | $1,489.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $862.46 / $1,015.05 / $1,194.17
| Professional | | $862.46 | $1,015.05 | $1,194.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.37 / $779.29 / $1,734.89
| Facility | | $626.37 | $779.29 | $1,734.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $706.48 / $911.61 / $1,434.78
| Professional | | $706.48 | $911.61 | $1,434.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,314.00 / $7,600.00
| Facility | | $1,154.00 | $3,314.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.13 / $772.93 / $1,194.52
| Professional | | $562.13 | $772.93 | $1,194.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $566.22 / $646.90 / $896.01
| Professional | | $566.22 | $646.90 | $896.01 |