- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $895.00 / $3,682.00 / $12,281.00
| Facility | | $895.00 | $3,682.00 | $12,281.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $818.45 / $986.25 / $1,587.42
| Professional | | $818.45 | $986.25 | $1,587.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $982.22 / $1,647.27 / $4,520.28
| Facility | | $982.22 | $1,647.27 | $4,520.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $791.98 / $1,005.32 / $1,540.63
| Professional | | $791.98 | $1,005.32 | $1,540.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $975.45 / $1,013.49
| Facility | | $80.00 | $975.45 | $1,013.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,132.69 / $1,132.69 / $1,132.69
| Facility | | $1,132.69 | $1,132.69 | $1,132.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $966.75 / $1,316.30 / $1,956.31
| Professional | | $966.75 | $1,316.30 | $1,956.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $10,131.48
| Facility | | $55.00 | $55.00 | $10,131.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,339.16 / $7,339.16 / $8,920.87
| Professional | | $7,339.16 | $7,339.16 | $8,920.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.93 / $1,119.80 / $2,127.46
| Facility | | $900.93 | $1,119.80 | $2,127.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,231.19 / $1,477.43 / $1,832.01
| Professional | | $1,231.19 | $1,477.43 | $1,832.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,034.09 / $1,034.09 / $1,034.09
| Professional | | $1,034.09 | $1,034.09 | $1,034.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $901.48 / $1,119.80 / $2,178.67
| Facility | | $901.48 | $1,119.80 | $2,178.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $974.91 / $1,351.39 / $1,994.89
| Professional | | $974.91 | $1,351.39 | $1,994.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.00 / $2,064.00 / $8,759.00
| Facility | | $432.00 | $2,064.00 | $8,759.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $768.68 / $1,024.91 / $1,605.72
| Professional | | $768.68 | $1,024.91 | $1,605.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $840.63 / $951.40 / $1,311.74
| Professional | | $840.63 | $951.40 | $1,311.74 |