- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.44 / $3,174.22 / $3,174.22
| Facility | | $506.44 | $3,174.22 | $3,174.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $481.56 / $560.32 / $680.65
| Professional | | $481.56 | $560.32 | $680.65 |
- 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
- $937.03 / $1,230.58 / $1,230.58
| Professional | | $937.03 | $1,230.58 | $1,230.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.89 / $741.89 / $1,230.58
| Facility | | $741.89 | $741.89 | $1,230.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.58 / $541.58 / $1,077.54
| Professional | | $541.58 | $541.58 | $1,077.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,132.13 / $1,230.58 / $2,338.10
| Professional | | $1,132.13 | $1,230.58 | $2,338.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $830.93 / $830.93 / $922.94
| Professional | | $830.93 | $830.93 | $922.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.44 / $3,174.22 / $3,174.22
| Facility | | $506.44 | $3,174.22 | $3,174.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.92 / $581.87 / $775.83
| Professional | | $418.92 | $581.87 | $775.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,525.70 / $1,754.60 / $2,424.50
| Professional | | $1,525.70 | $1,754.60 | $2,424.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.89 / $741.89 / $1,230.58
| Facility | | $741.89 | $741.89 | $1,230.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.58 / $541.58 / $1,461.75
| Professional | | $541.58 | $541.58 | $1,461.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $879.79 / $1,171.29 / $1,171.29
| Facility | | $879.79 | $1,171.29 | $1,171.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $879.79 / $1,171.29 / $1,200.00
| Professional | | $879.79 | $1,171.29 | $1,200.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.24 / $620.05 / $1,109.71
| Professional | | $468.24 | $620.05 | $1,109.71 |