- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.71 / $1,840.69 / $2,022.27
| Facility | | $234.71 | $1,840.69 | $2,022.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.12 / $248.51 / $311.72
| Professional | | $205.12 | $248.51 | $311.72 |
- 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
- $400.20 / $525.58 / $525.58
| Professional | | $400.20 | $525.58 | $525.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.61 / $420.61 / $524.12
| Facility | | $420.61 | $420.61 | $524.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.52 / $357.52 / $458.94
| Professional | | $357.52 | $357.52 | $458.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.19 / $524.12 / $995.83
| Professional | | $482.19 | $524.12 | $995.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,772.54 / $1,772.54 / $2,061.42
| Facility | | $1,772.54 | $1,772.54 | $2,061.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.54 / $1,840.69 / $2,246.88
| Facility | | $816.54 | $1,840.69 | $2,246.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.12 / $248.51 / $391.77
| Professional | | $205.12 | $248.51 | $391.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.60 / $246.50 / $1,032.59
| Professional | | $187.60 | $246.50 | $1,032.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.61 / $420.61 / $524.12
| Facility | | $420.61 | $420.61 | $524.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.52 / $357.52 / $609.38
| Professional | | $357.52 | $357.52 | $609.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.44 / $363.44 / $500.25
| Facility | | $363.44 | $363.44 | $500.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.44 / $500.25 / $500.25
| Professional | | $363.44 | $500.25 | $500.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.98 / $296.23 / $459.21
| Professional | | $236.98 | $296.23 | $459.21 |