- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,981.07 / $8,317.64
| Facility | | $660.69 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $331.13 / $851.14
| Professional | | $275.42 | $331.13 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $5,248.07 / $57,543.99
| Facility | | $5,011.87 | $5,248.07 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $512.86 / $562.34
| Professional | | $478.63 | $512.86 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $398.11 / $660.69
| Professional | | $295.12 | $398.11 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $467.74 / $512.86
| Professional | | $363.08 | $467.74 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $407.38 / $630.96
| Professional | | $295.12 | $407.38 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $10,232.93
| Facility | | $6,760.83 | $6,760.83 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $3,715.35 / $8,317.64
| Facility | | $776.25 | $3,715.35 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $426.58 / $1,096.48
| Professional | | $295.12 | $426.58 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $691.83
| Facility | | $371.54 | $371.54 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $524.81 / $660.69
| Professional | | $338.84 | $524.81 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $331.13 / $467.74
| Facility | | $302.00 | $331.13 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $346.74 / $467.74
| Professional | | $316.23 | $346.74 | $467.74 |
- 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
- $281.84 / $371.54 / $645.65
| Professional | | $281.84 | $371.54 | $645.65 |