- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,682.00 / $12,281.00
| Facility | | $969.00 | $3,682.00 | $12,281.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,309.79 / $1,587.80 / $2,544.86
| Professional | | $1,309.79 | $1,587.80 | $2,544.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,268.14 / $1,715.67 / $2,499.73
| Professional | | $1,268.14 | $1,715.67 | $2,499.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $1,525.58 / $1,599.41
| Facility | | $80.00 | $1,525.58 | $1,599.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,828.45 / $3,603.00 / $6,702.00
| Facility | | $1,828.45 | $3,603.00 | $6,702.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,599.93 / $2,165.98 / $3,185.11
| Professional | | $1,599.93 | $2,165.98 | $3,185.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $5,000.00 / $19,844.00
| Facility | | $55.00 | $5,000.00 | $19,844.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11,137.08 / $11,343.28 / $14,387.63
| Professional | | $11,137.08 | $11,343.28 | $14,387.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.47 / $1,890.27 / $3,052.05
| Facility | | $1,481.47 | $1,890.27 | $3,052.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,979.20 / $2,375.04 / $2,945.05
| Professional | | $1,979.20 | $2,375.04 | $2,945.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,806.28 / $2,683.06 / $5,884.03
| Professional | | $1,806.28 | $2,683.06 | $5,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,493.37 / $1,891.13 / $3,258.35
| Facility | | $1,493.37 | $1,891.13 | $3,258.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,613.79 / $2,226.38 / $3,292.83
| Professional | | $1,613.79 | $2,226.38 | $3,292.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $2,546.00 / $9,000.00
| Facility | | $500.00 | $2,546.00 | $9,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,263.17 / $1,711.06 / $2,694.77
| Professional | | $1,263.17 | $1,711.06 | $2,694.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,351.35 / $1,532.54 / $2,104.56
| Professional | | $1,351.35 | $1,532.54 | $2,104.56 |