- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $349.94 / $3,623.00 / $7,799.00
| Facility | | $349.94 | $3,623.00 | $7,799.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.50 / $257.70 / $391.56
| Professional | | $188.50 | $257.70 | $391.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.51 / $1,395.00 / $12,759.45
| Facility | | $1,083.51 | $1,395.00 | $12,759.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.00 / $382.92 / $599.85
| Professional | | $369.00 | $382.92 | $599.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.67 / $327.91 / $569.60
| Professional | | $225.67 | $327.91 | $569.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.94 / $573.35 / $592.96
| Professional | | $445.94 | $573.35 | $592.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $3,839.00 / $8,017.00
| Facility | | $832.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.96 / $328.19 / $1,820.00
| Professional | | $220.96 | $328.19 | $1,820.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.60 / $329.60 / $346.10
| Professional | | $329.60 | $329.60 | $346.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.85 / $431.85 / $431.85
| Facility | | $431.85 | $431.85 | $431.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.31 / $334.99 / $586.50
| Professional | | $229.31 | $334.99 | $586.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.86 / $248.28 / $366.21
| Facility | | $213.86 | $248.28 | $366.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.16 / $266.50 / $391.70
| Professional | | $240.16 | $266.50 | $391.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.00 / $650.00 / $4,300.00
| Facility | | $144.00 | $650.00 | $4,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.51 / $383.60 / $726.54
| Professional | | $285.51 | $383.60 | $726.54 |