- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.00 / $2,128.00 / $7,513.00
| Facility | | $524.00 | $2,128.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.82 / $568.46 / $948.93
| Professional | | $316.82 | $568.46 | $948.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,530.22 / $2,699.38 / $5,381.57
| Facility | | $1,530.22 | $2,699.38 | $5,381.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.61 / $594.59 / $920.18
| Professional | | $325.61 | $594.59 | $920.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.08 / $2,288.87 / $2,288.87
| Facility | | $410.08 | $2,288.87 | $2,288.87 |
- 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
- $403.45 / $687.95 / $1,173.23
| Professional | | $403.45 | $687.95 | $1,173.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.94 / $11,500.00 / $12,000.00
| Facility | | $1,967.94 | $11,500.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,557.39 / $6,251.76 / $7,722.75
| Professional | | $3,557.39 | $6,251.76 | $7,722.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.20 / $646.36 / $1,115.96
| Facility | | $345.20 | $646.36 | $1,115.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.65 / $1,017.61 / $1,613.61
| Professional | | $546.65 | $1,017.61 | $1,613.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.60 / $945.50 / $2,000.63
| Professional | | $446.60 | $945.50 | $2,000.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.62 / $650.04 / $1,120.68
| Facility | | $345.62 | $650.04 | $1,120.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.26 / $719.70 / $1,239.44
| Professional | | $418.26 | $719.70 | $1,239.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,326.00 / $7,600.00
| Facility | | $1,154.00 | $3,326.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.34 / $675.28 / $1,061.58
| Professional | | $482.34 | $675.28 | $1,061.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $740.41 / $829.05 / $1,167.24
| Professional | | $740.41 | $829.05 | $1,167.24 |