- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.92 / $10,596.56 / $22,024.00
| Facility | | $331.92 | $10,596.56 | $22,024.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.70 / $331.92 / $376.40
| Professional | | $298.70 | $331.92 | $376.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.43 / $503.31 / $1,107.28
| Facility | | $419.43 | $503.31 | $1,107.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $441.00 / $787.67 / $2,942.03
| Professional | | $441.00 | $787.67 | $2,942.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $734.00 / $734.00 / $734.00
| Facility | | $734.00 | $734.00 | $734.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.01 / $530.01 / $530.01
| Professional | | $530.01 | $530.01 | $530.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,031.07 / $1,031.07 / $1,031.07
| Professional | | $1,031.07 | $1,031.07 | $1,031.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.00 / $45.00 / $50.00
| Professional | | $45.00 | $45.00 | $50.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.11 / $646.59 / $675.36
| Facility | | $442.11 | $646.59 | $675.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $429.44 / $429.44 / $460.66
| Facility | | $429.44 | $429.44 | $460.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.16 / $722.09 / $914.36
| Professional | | $474.16 | $722.09 | $914.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.43 / $503.31 / $956.29
| Facility | | $419.43 | $503.31 | $956.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.98 / $628.33 / $872.93
| Professional | | $437.98 | $628.33 | $872.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $1,050.00 / $5,793.00
| Facility | | $500.00 | $1,050.00 | $5,793.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.21 / $520.85 / $916.26
| Professional | | $407.21 | $520.85 | $916.26 |