- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.17 / $2,110.53 / $14,702.81
| Facility | | $358.17 | $2,110.53 | $14,702.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.27 / $612.60 / $6,310.53
| Professional | | $509.27 | $612.60 | $6,310.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.95 / $332.44 / $332.44
| Facility | | $265.95 | $332.44 | $332.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $547.50 / $615.05 / $627.35
| Professional | | $547.50 | $615.05 | $627.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.36 / $922.68 / $1,845.36
| Facility | | $627.36 | $922.68 | $1,845.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $627.36 / $627.36 / $627.36
| Professional | | $627.36 | $627.36 | $627.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $701.17 / $1,577.63
| Facility | | $319.00 | $701.17 | $1,577.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $533.26 / $627.36 / $627.36
| Professional | | $533.26 | $627.36 | $627.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.36 / $651.96 / $651.96
| Facility | | $627.36 | $651.96 | $651.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $627.36 / $627.36 / $651.96
| Professional | | $627.36 | $627.36 | $651.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.83 / $536.60 / $836.00
| Facility | | $105.83 | $536.60 | $836.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $861.17 / $1,845.36
| Facility | | $597.00 | $861.17 | $1,845.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $627.36 / $627.36 / $627.36
| Professional | | $627.36 | $627.36 | $627.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $615.05 / $615.05 / $922.59
| Professional | | $615.05 | $615.05 | $922.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.36 / $627.36 / $627.36
| Facility | | $627.36 | $627.36 | $627.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $627.36 / $627.36 / $651.96
| Professional | | $627.36 | $627.36 | $651.96 |