- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.97 / $1,839.54 / $2,829.33
| Facility | | $547.97 | $1,839.54 | $2,829.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.61 / $554.73 / $1,014.75
| Professional | | $500.61 | $554.73 | $1,014.75 |
- 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
- $527.66 / $527.66 / $527.66
| Professional | | $527.66 | $527.66 | $527.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $642.01 / $999.35 / $2,244.92
| Facility | | $642.01 | $999.35 | $2,244.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.33 / $722.38 / $1,530.04
| Professional | | $335.33 | $722.38 | $1,530.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.52 / $913.28 / $1,326.58
| Professional | | $402.52 | $913.28 | $1,326.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,017.52 / $1,362.40 / $2,395.60
| Facility | | $1,017.52 | $1,362.40 | $2,395.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.03 / $1,839.54 / $2,793.95
| Facility | | $575.03 | $1,839.54 | $2,793.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.61 / $668.50 / $2,793.95
| Professional | | $500.61 | $668.50 | $2,793.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,001.22 / $1,014.75 / $1,353.00
| Professional | | $1,001.22 | $1,014.75 | $1,353.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $658.34 / $1,125.49 / $2,244.92
| Facility | | $658.34 | $1,125.49 | $2,244.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.11 / $724.17 / $1,530.04
| Professional | | $356.11 | $724.17 | $1,530.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.50 / $676.50 / $865.91
| Facility | | $676.50 | $676.50 | $865.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.50 / $676.50 / $865.91
| Professional | | $676.50 | $676.50 | $865.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.13 / $405.90 / $947.10
| Professional | | $284.13 | $405.90 | $947.10 |