- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.44 / $3,839.00 / $8,247.00
| Facility | | $470.44 | $3,839.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.76 / $470.44 / $688.29
| Professional | | $430.76 | $470.44 | $688.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.88 / $633.65 / $915.45
| Professional | | $419.88 | $633.65 | $915.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $516.44 / $704.93 / $1,212.82
| Professional | | $516.44 | $704.93 | $1,212.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $696.62 / $696.62 / $716.10
| Professional | | $696.62 | $696.62 | $716.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,761.00 / $8,247.00
| Facility | | $657.00 | $4,761.00 | $8,247.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.90 / $632.04 / $2,463.46
| Professional | | $432.90 | $632.04 | $2,463.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $788.80 / $1,299.59
| Professional | | $10.00 | $788.80 | $1,299.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $519.89 / $704.93 / $1,269.86
| Professional | | $519.89 | $704.93 | $1,269.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.16 / $501.16 / $501.16
| Facility | | $501.16 | $501.16 | $501.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.16 / $501.16 / $501.16
| Professional | | $501.16 | $501.16 | $501.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.00 / $2,391.00 / $6,228.00
| Facility | | $656.00 | $2,391.00 | $6,228.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.18 / $701.37 / $995.07
| Professional | | $503.18 | $701.37 | $995.07 |