- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $288.40 / $794.33
| Professional | | $239.88 | $288.40 | $794.33 |
- 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
- $257.04 / $371.54 / $501.19
| Professional | | $257.04 | $371.54 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $354.81 / $575.44
| Professional | | $263.03 | $354.81 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $398.11 / $436.52
| Professional | | $309.03 | $398.11 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $354.81 / $562.34
| Professional | | $269.15 | $354.81 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,011.87 / $6,025.60
| Facility | | $1,698.24 | $5,011.87 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,344.23 / $7,943.28
| Facility | | $537.03 | $2,344.23 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $371.54 / $912.01
| Professional | | $251.19 | $371.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $588.84
| Facility | | $380.19 | $380.19 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $446.68 / $602.56
| Professional | | $323.59 | $446.68 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $338.84 / $407.38
| Facility | | $281.84 | $338.84 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $288.40 / $407.38
| Professional | | $95.50 | $288.40 | $407.38 |
- 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
- $251.19 / $331.13 / $575.44
| Professional | | $251.19 | $331.13 | $575.44 |