- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.40 / $545.40 / $1,382.73
| Facility | | $545.40 | $545.40 | $1,382.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $921.82 / $921.82 / $1,360.35
| Professional | | $921.82 | $921.82 | $1,360.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.92 / $5,821.21 / $8,577.84
| Facility | | $5,456.92 | $5,821.21 | $8,577.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,381.00 / $1,622.63 / $1,727.00
| Professional | | $1,381.00 | $1,622.63 | $1,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $693.56 / $800.00 / $3,312.00
| Facility | | $693.56 | $800.00 | $3,312.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $797.59 / $800.00 / $3,312.00
| Professional | | $797.59 | $800.00 | $3,312.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $737.26 / $737.26 / $909.64
| Facility | | $737.26 | $737.26 | $909.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $700.00 / $1,112.00
| Facility | | $40.00 | $700.00 | $1,112.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.00 / $568.92 / $755.00
| Professional | | $40.00 | $568.92 | $755.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,459.81 / $4,989.45 / $4,989.45
| Facility | | $4,459.81 | $4,989.45 | $4,989.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $901.20 / $921.82 / $921.82
| Facility | | $901.20 | $921.82 | $921.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,098.06 / $1,098.06 / $1,098.06
| Facility | | $1,098.06 | $1,098.06 | $1,098.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $901.20 / $1,112.00
| Facility | | $40.00 | $901.20 | $1,112.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.00 / $568.92 / $755.00
| Professional | | $40.00 | $568.92 | $755.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.88 / $769.01 / $1,088.92
| Professional | | $541.88 | $769.01 | $1,088.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.44 / $272.44 / $272.44
| Professional | | $272.44 | $272.44 | $272.44 |