- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.07 / $1,836.55 / $2,824.72
| Facility | | $547.07 | $1,836.55 | $2,824.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $424.13 / $553.83 / $1,013.09
| Professional | | $424.13 | $553.83 | $1,013.09 |
- 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
- $526.80 / $526.80 / $526.80
| Professional | | $526.80 | $526.80 | $526.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.95 / $997.90 / $2,241.66
| Facility | | $640.95 | $997.90 | $2,241.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.69 / $721.30 / $1,527.82
| Professional | | $299.69 | $721.30 | $1,527.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.86 / $911.79 / $1,660.29
| Professional | | $401.86 | $911.79 | $1,660.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $633.20 / $1,015.87 / $1,360.18
| Facility | | $633.20 | $1,015.87 | $1,360.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.09 / $1,836.55 / $2,789.40
| Facility | | $574.09 | $1,836.55 | $2,789.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.29 / $640.00 / $2,789.40
| Professional | | $486.29 | $640.00 | $2,789.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $999.59 / $1,013.10 / $1,350.80
| Professional | | $999.59 | $1,013.10 | $1,350.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.40 / $1,123.65 / $2,241.66
| Facility | | $657.40 | $1,123.65 | $2,241.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.35 / $723.12 / $1,527.82
| Professional | | $316.35 | $723.12 | $1,527.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.40 / $675.40 / $716.23
| Facility | | $675.40 | $675.40 | $716.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $675.40 / $675.40 / $716.23
| Professional | | $675.40 | $675.40 | $716.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.67 / $405.24 / $901.79
| Professional | | $283.67 | $405.24 | $901.79 |