- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.00 / $2,768.00 / $7,542.00
| Facility | | $669.00 | $2,768.00 | $7,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.43 / $536.98 / $858.42
| Professional | | $418.43 | $536.98 | $858.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,310.01 / $6,376.61 / $13,287.56
| Facility | | $2,310.01 | $6,376.61 | $13,287.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.46 / $555.26 / $760.49
| Professional | | $448.46 | $555.26 | $760.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.69 / $421.69 / $440.37
| Facility | | $421.69 | $421.69 | $440.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,578.19 / $2,578.19 / $2,662.46
| Facility | | $2,578.19 | $2,578.19 | $2,662.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.05 / $610.77 / $906.76
| Professional | | $466.05 | $610.77 | $906.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $16,394.00 / $16,394.00
| Facility | | $11,500.00 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,606.16 / $3,718.32 / $4,103.47
| Professional | | $3,606.16 | $3,718.32 | $4,103.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.95 / $587.70 / $876.40
| Facility | | $471.95 | $587.70 | $876.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $464.01 / $719.55 / $4,663.00
| Professional | | $464.01 | $719.55 | $4,663.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $454.73 / $556.80 / $959.58
| Professional | | $454.73 | $556.80 | $959.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.95 / $594.76 / $955.01
| Facility | | $471.95 | $594.76 | $955.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.26 / $636.66 / $949.88
| Professional | | $465.26 | $636.66 | $949.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $3,326.00 / $7,600.00
| Facility | | $1,120.00 | $3,326.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.65 / $508.86 / $759.19
| Professional | | $381.65 | $508.86 | $759.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.41 / $464.01 / $650.41
| Professional | | $409.41 | $464.01 | $650.41 |