- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,890.77 / $3,786.91 / $9,250.45
| Facility | | $2,890.77 | $3,786.91 | $9,250.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,868.70 / $2,467.12 / $2,902.82
| Professional | | $1,868.70 | $2,467.12 | $2,902.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $8,639.91 / $79,506.39
| Facility | | $5,000.00 | $8,639.91 | $79,506.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $978.22 / $3,141.54 / $3,260.09
| Professional | | $978.22 | $3,141.54 | $3,260.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $486.93 / $1,162.63 / $7,546.28
| Facility | | $486.93 | $1,162.63 | $7,546.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.33 / $603.30 / $937.48
| Professional | | $355.33 | $603.30 | $937.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $623.30 / $805.48 / $1,622.67
| Professional | | $623.30 | $805.48 | $1,622.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,890.77 / $3,786.91 / $9,452.82
| Facility | | $2,890.77 | $3,786.91 | $9,452.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,118.52 / $2,698.73 / $3,268.15
| Professional | | $2,118.52 | $2,698.73 | $3,268.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.80 / $676.80 / $912.40
| Professional | | $676.80 | $676.80 | $912.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.96 / $1,062.76 / $7,570.74
| Facility | | $478.96 | $1,062.76 | $7,570.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.27 / $599.52 / $952.13
| Professional | | $360.27 | $599.52 | $952.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.00 / $553.03 / $553.03
| Facility | | $544.00 | $553.03 | $553.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $544.00 / $553.03 / $652.32
| Professional | | $544.00 | $553.03 | $652.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.53 / $1,667.94 / $3,260.10
| Professional | | $478.53 | $1,667.94 | $3,260.10 |