- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.82 / $485.82 / $1,880.12
| Facility | | $485.82 | $485.82 | $1,880.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.96 / $537.50 / $684.75
| Professional | | $461.96 | $537.50 | $684.75 |
- 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
- $898.87 / $1,180.47 / $1,180.47
| Professional | | $898.87 | $1,180.47 | $1,180.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $944.53 / $944.53 / $1,180.47
| Facility | | $944.53 | $944.53 | $1,180.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $689.51 / $689.51 / $1,033.66
| Professional | | $689.51 | $689.51 | $1,033.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,086.03 / $1,180.47 / $2,242.89
| Professional | | $1,086.03 | $1,180.47 | $2,242.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $885.35 / $885.35 / $885.35
| Professional | | $885.35 | $885.35 | $885.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.82 / $485.82 / $1,880.12
| Facility | | $485.82 | $485.82 | $1,880.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.96 / $558.17 / $944.38
| Professional | | $461.96 | $558.17 | $944.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,463.60 / $1,683.20 / $2,325.69
| Professional | | $1,463.60 | $1,683.20 | $2,325.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $944.53 / $944.53 / $1,180.47
| Facility | | $944.53 | $944.53 | $1,180.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $689.51 / $689.51 / $1,402.13
| Professional | | $689.51 | $689.51 | $1,402.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.98 / $1,123.58 / $1,123.58
| Facility | | $843.98 | $1,123.58 | $1,123.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $843.98 / $1,123.58 / $1,151.21
| Professional | | $843.98 | $1,123.58 | $1,151.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $449.20 / $591.40 / $1,064.54
| Professional | | $449.20 | $591.40 | $1,064.54 |