- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,981.07 / $8,317.64
| Facility | | $1,047.13 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $446.68 / $1,148.15
| Professional | | $371.54 | $446.68 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $549.54 / $707.95
| Professional | | $467.74 | $549.54 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $549.54 / $912.01
| Professional | | $407.38 | $549.54 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $630.96 / $707.95
| Professional | | $489.78 | $630.96 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $549.54 / $870.96
| Professional | | $407.38 | $549.54 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,818.38 / $8,317.64
| Facility | | $954.99 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $537.03 / $1,412.54
| Professional | | $389.05 | $537.03 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $478.63 / $933.25
| Facility | | $478.63 | $478.63 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $724.44 / $933.25
| Professional | | $446.68 | $724.44 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $416.87 / $446.68
| Facility | | $380.19 | $416.87 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $416.87 / $478.63
| Professional | | $380.19 | $416.87 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $10,000.00
| Facility | | $1,348.96 | $3,548.13 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $512.86 / $891.25
| Professional | | $389.05 | $512.86 | $891.25 |