- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.48 / $1,278.80 / $5,124.60
| Facility | | $335.48 | $1,278.80 | $5,124.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.30 / $355.22 / $2,356.86
| Professional | | $293.30 | $355.22 | $2,356.86 |
- 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
- $572.03 / $751.24 / $751.24
| Professional | | $572.03 | $751.24 | $751.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.06 / $666.06 / $749.49
| Facility | | $666.06 | $666.06 | $749.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $566.15 / $566.15 / $686.04
| Professional | | $566.15 | $566.15 | $686.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $689.53 / $749.49 / $1,424.03
| Professional | | $689.53 | $749.49 | $1,424.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,485.82 / $3,755.18 / $4,788.47
| Facility | | $2,485.82 | $3,755.18 | $4,788.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.48 / $1,827.98 / $5,483.90
| Facility | | $335.48 | $1,827.98 | $5,483.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.30 / $368.37 / $2,356.86
| Professional | | $293.30 | $368.37 | $2,356.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.60 / $1,022.20 / $1,476.60
| Professional | | $507.60 | $1,022.20 | $1,476.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.06 / $666.06 / $749.49
| Facility | | $666.06 | $666.06 | $749.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $566.15 / $566.15 / $1,158.38
| Professional | | $566.15 | $566.15 | $1,158.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $519.49 / $519.49 / $715.04
| Facility | | $519.49 | $519.49 | $715.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $519.49 / $715.04 / $729.34
| Professional | | $519.49 | $715.04 | $729.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.96 / $439.15 / $677.47
| Professional | | $351.96 | $439.15 | $677.47 |