- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.35 / $532.35 / $2,060.19
| Facility | | $532.35 | $532.35 | $2,060.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.47 / $588.98 / $678.94
| Professional | | $466.47 | $588.98 | $678.94 |
- 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
- $984.95 / $1,293.52 / $1,293.52
| Professional | | $984.95 | $1,293.52 | $1,293.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.00 / $700.00 / $1,359.01
| Facility | | $700.00 | $700.00 | $1,359.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.00 / $511.00 / $1,199.82
| Professional | | $511.00 | $511.00 | $1,199.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,260.60 / $1,370.23 / $2,603.44
| Professional | | $1,260.60 | $1,370.23 | $2,603.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $873.45 / $905.46 / $970.14
| Professional | | $873.45 | $905.46 | $970.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.35 / $532.35 / $2,060.19
| Facility | | $532.35 | $532.35 | $2,060.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.90 / $611.63 / $963.55
| Professional | | $340.90 | $611.63 | $963.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $928.00 / $1,783.90 / $2,699.60
| Professional | | $928.00 | $1,783.90 | $2,699.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.00 / $700.00 / $1,359.01
| Facility | | $700.00 | $700.00 | $1,359.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.00 / $511.00 / $1,308.75
| Professional | | $511.00 | $511.00 | $1,308.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $894.49 / $1,231.19 / $1,231.19
| Facility | | $894.49 | $1,231.19 | $1,231.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $894.49 / $1,231.19 / $1,304.20
| Professional | | $894.49 | $1,231.19 | $1,304.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.00 / $480.00 / $480.00
| Facility | | $480.00 | $480.00 | $480.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $440.97 / $645.32 / $1,075.54
| Professional | | $440.97 | $645.32 | $1,075.54 |