- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.00 / $2,768.00 / $7,542.00
| Facility | | $661.00 | $2,768.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.23 / $504.70 / $805.76
| Professional | | $423.23 | $504.70 | $805.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,530.22 / $2,716.57 / $5,381.57
| Facility | | $1,530.22 | $2,716.57 | $5,381.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.09 / $598.82 / $815.24
| Professional | | $473.09 | $598.82 | $815.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $522.94 / $537.53
| Facility | | $80.00 | $522.94 | $537.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.90 / $582.90 / $582.90
| Facility | | $582.90 | $582.90 | $582.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $494.19 / $653.30 / $976.67
| Professional | | $494.19 | $653.30 | $976.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,909.22 / $11,500.00 / $16,394.00
| Facility | | $2,909.22 | $11,500.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,589.52 / $3,665.92 / $4,570.58
| Professional | | $3,589.52 | $3,665.92 | $4,570.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.86 / $553.00 / $910.59
| Facility | | $439.86 | $553.00 | $910.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $633.59 / $760.31 / $942.78
| Professional | | $633.59 | $760.31 | $942.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.40 / $613.88 / $659.52
| Professional | | $493.40 | $613.88 | $659.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.86 / $553.14 / $981.03
| Facility | | $439.86 | $553.14 | $981.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.91 / $673.49 / $1,014.53
| Professional | | $501.91 | $673.49 | $1,014.53 |
- 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
- $386.52 / $515.36 / $818.06
| Professional | | $386.52 | $515.36 | $818.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.60 / $488.34 / $676.78
| Professional | | $432.60 | $488.34 | $676.78 |