- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,981.07 / $8,317.64
| Facility | | $1,047.13 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $436.52 / $933.25
| Professional | | $371.54 | $436.52 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $512.86 / $812.83
| Professional | | $416.87 | $512.86 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $575.44 / $891.25
| Professional | | $407.38 | $575.44 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $645.65 / $724.44
| Professional | | $512.86 | $645.65 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $562.34 / $758.58
| Professional | | $426.58 | $562.34 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $7,762.47 / $10,471.29
| Facility | | $7,762.47 | $7,762.47 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,090.30 / $8,317.64
| Facility | | $954.99 | $3,090.30 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $524.81 / $1,479.11
| Professional | | $371.54 | $524.81 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $741.31 / $870.96
| Professional | | $5.01 | $741.31 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $467.74 / $467.74
| Facility | | $446.68 | $467.74 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $467.74 / $478.63
| Professional | | $407.38 | $467.74 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,981.07 / $10,000.00
| Facility | | $2,137.96 | $3,981.07 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $512.86 / $851.14
| Professional | | $363.08 | $512.86 | $851.14 |