- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $2,127.73 / $6,012.00
| Facility | | $540.00 | $2,127.73 | $6,012.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.82 / $552.50 / $785.78
| Professional | | $316.82 | $552.50 | $785.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $764.27 / $899.14 / $1,365.47
| Professional | | $764.27 | $899.14 | $1,365.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.87 / $724.87 / $724.87
| Facility | | $724.87 | $724.87 | $724.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.78 / $647.53 / $1,185.06
| Professional | | $361.78 | $647.53 | $1,185.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,056.78 / $1,448.09 / $1,825.35
| Professional | | $1,056.78 | $1,448.09 | $1,825.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,600.68 / $4,600.68 / $4,600.68
| Facility | | $4,600.68 | $4,600.68 | $4,600.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.00 / $2,127.73 / $8,017.00
| Facility | | $617.00 | $2,127.73 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.82 / $618.99 / $1,832.79
| Professional | | $316.82 | $618.99 | $1,832.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.10 / $426.20 / $1,355.60
| Professional | | $426.10 | $426.20 | $1,355.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.87 / $724.87 / $724.87
| Facility | | $724.87 | $724.87 | $724.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.15 / $659.16 / $1,284.47
| Professional | | $373.15 | $659.16 | $1,284.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.42 / $343.45 / $626.74
| Facility | | $325.42 | $343.45 | $626.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.28 / $456.33 / $673.65
| Professional | | $331.28 | $456.33 | $673.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,334.00 / $2,824.00 / $5,678.00
| Facility | | $1,334.00 | $2,824.00 | $5,678.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.28 / $777.42 / $1,233.58
| Professional | | $579.28 | $777.42 | $1,233.58 |