- 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
- $322.08 / $367.43 / $514.63
| Professional | | $322.08 | $367.43 | $514.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,023.00 / $4,346.70 / $8,572.65
| Facility | | $2,023.00 | $4,346.70 | $8,572.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.47 / $315.47 / $315.47
| Facility | | $315.47 | $315.47 | $315.47 |
- 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
- $358.85 / $467.55 / $725.55
| Professional | | $358.85 | $467.55 | $725.55 |
- 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
- $5,174.55 / $5,174.55 / $5,174.55
| Professional | | $5,174.55 | $5,174.55 | $5,174.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.23 / $448.80 / $914.19
| Facility | | $345.23 | $448.80 | $914.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $443.21 / $521.62 / $613.66
| Professional | | $443.21 | $521.62 | $613.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.60 / $506.60 / $506.60
| Professional | | $506.60 | $506.60 | $506.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.23 / $453.51 / $914.19
| Facility | | $345.23 | $453.51 | $914.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.45 / $472.30 / $768.03
| Professional | | $364.45 | $472.30 | $768.03 |
- 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
- $288.43 / $396.59 / $642.84
| Professional | | $288.43 | $396.59 | $642.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.97 / $332.02 / $460.55
| Professional | | $290.97 | $332.02 | $460.55 |