- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.03 / $3,316.00 / $8,750.71
| Facility | | $235.03 | $3,316.00 | $8,750.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.50 / $218.06 / $472.60
| Professional | | $168.50 | $218.06 | $472.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,393.00 / $4,120.00 / $8,836.00
| Facility | | $2,393.00 | $4,120.00 | $8,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.96 / $263.45 / $508.84
| Professional | | $218.96 | $263.45 | $508.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.35 / $1,716.00 / $6,213.00
| Facility | | $263.35 | $1,716.00 | $6,213.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.35 / $263.35 / $340.22
| Professional | | $263.35 | $263.35 | $340.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.77 / $317.77 / $4,612.43
| Facility | | $317.77 | $317.77 | $4,612.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.24 / $331.31 / $757.02
| Professional | | $193.24 | $331.31 | $757.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.00 / $282.00 / $494.73
| Facility | | $190.00 | $282.00 | $494.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.02 / $331.95 / $496.78
| Professional | | $287.02 | $331.95 | $496.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.42 / $283.95 / $454.61
| Professional | | $176.42 | $283.95 | $454.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,265.44 / $5,331.32 / $10,239.64
| Facility | | $3,265.44 | $5,331.32 | $10,239.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.77 / $555.00 / $4,612.43
| Facility | | $317.77 | $555.00 | $4,612.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.95 / $360.85 / $757.02
| Professional | | $218.95 | $360.85 | $757.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,031.00 / $4,840.00 / $9,202.00
| Facility | | $2,031.00 | $4,840.00 | $9,202.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.74 / $311.94 / $578.11
| Professional | | $218.74 | $311.94 | $578.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.12 / $216.12 / $592.88
| Facility | | $216.12 | $216.12 | $592.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.42 / $297.60 / $501.45
| Professional | | $176.42 | $297.60 | $501.45 |