- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $538.88 / $1,007.71 / $1,867.00
| Facility | | $538.88 | $1,007.71 | $1,867.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.31 / $513.07 / $736.74
| Professional | | $444.31 | $513.07 | $736.74 |
- 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
- $549.96 / $570.71 / $936.87
| Professional | | $549.96 | $570.71 | $936.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $304.20 / $848.93 / $1,865.39
| Facility | | $304.20 | $848.93 | $1,865.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.01 / $615.40 / $967.57
| Professional | | $441.01 | $615.40 | $967.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.91 / $708.17 / $861.17
| Professional | | $535.91 | $708.17 | $861.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $558.83 / $1,016.91 / $1,880.69
| Facility | | $558.83 | $1,016.91 | $1,880.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.31 / $531.13 / $2,128.58
| Professional | | $444.31 | $531.13 | $2,128.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $388.13 / $576.50 / $1,056.68
| Professional | | $388.13 | $576.50 | $1,056.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.24 / $834.75 / $1,865.39
| Facility | | $285.24 | $834.75 | $1,865.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.40 / $629.41 / $985.82
| Professional | | $447.40 | $629.41 | $985.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.63 / $531.29 / $531.29
| Facility | | $409.63 | $531.29 | $531.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.63 / $531.29 / $567.58
| Professional | | $409.63 | $531.29 | $567.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.51 / $580.77 / $970.47
| Professional | | $432.51 | $580.77 | $970.47 |