- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.36 / $193.36 / $657.27
| Facility | | $193.36 | $193.36 | $657.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.77 / $333.89 / $468.35
| Professional | | $305.77 | $333.89 | $468.35 |
- 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
- $537.69 / $706.13 / $706.13
| Professional | | $537.69 | $706.13 | $706.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $502.54 / $502.54 / $832.06
| Facility | | $502.54 | $502.54 | $832.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.16 / $427.16 / $728.58
| Professional | | $427.16 | $427.16 | $728.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $765.50 / $832.06 / $1,580.91
| Professional | | $765.50 | $832.06 | $1,580.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.28 / $113.28 / $113.28
| Facility | | $113.28 | $113.28 | $113.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.62 / $193.36 / $2,150.00
| Facility | | $155.62 | $193.36 | $2,150.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.16 / $343.93 / $474.76
| Professional | | $309.16 | $343.93 | $474.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.60 / $1,038.09 / $1,639.30
| Professional | | $514.60 | $1,038.09 | $1,639.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $502.54 / $502.54 / $832.06
| Facility | | $502.54 | $502.54 | $832.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.16 / $427.16 / $951.38
| Professional | | $427.16 | $427.16 | $951.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.31 / $488.31 / $672.11
| Facility | | $488.31 | $488.31 | $672.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.31 / $672.11 / $791.97
| Professional | | $488.31 | $672.11 | $791.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.28 / $415.11 / $636.82
| Professional | | $330.28 | $415.11 | $636.82 |