- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.00 / $2,578.00 / $8,328.00
| Facility | | $569.00 | $2,578.00 | $8,328.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.55 / $422.79 / $679.43
| Professional | | $279.55 | $422.79 | $679.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,994.25 / $3,640.66 / $7,026.24
| Facility | | $1,994.25 | $3,640.66 | $7,026.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $306.26 / $486.06 / $678.32
| Professional | | $306.26 | $486.06 | $678.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.02 / $311.02 / $553.77
| Facility | | $311.02 | $311.02 | $553.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.97 / $521.04 / $789.50
| Professional | | $348.97 | $521.04 | $789.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,683.21 / $16,394.00 / $16,394.00
| Facility | | $1,683.21 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,401.28 / $3,749.28 / $4,470.89
| Professional | | $2,401.28 | $3,749.28 | $4,470.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.83 / $478.09 / $687.08
| Facility | | $311.83 | $478.09 | $687.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $409.99 / $638.44 / $950.00
| Professional | | $409.99 | $638.44 | $950.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.97 / $490.20 / $650.44
| Professional | | $315.97 | $490.20 | $650.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.83 / $478.68 / $705.77
| Facility | | $311.83 | $478.68 | $705.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.04 / $543.84 / $879.63
| Professional | | $358.04 | $543.84 | $879.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.00 / $3,239.00 / $7,600.00
| Facility | | $1,154.00 | $3,239.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $382.46 / $524.74 / $743.03
| Professional | | $382.46 | $524.74 | $743.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.91 / $490.20 / $686.28
| Professional | | $435.91 | $490.20 | $686.28 |