- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $347.99 / $2,747.00 / $4,806.64
| Facility | | $347.99 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.99 / $502.26 / $813.36
| Professional | | $347.99 | $502.26 | $813.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.00 / $1,922.99 / $3,804.00
| Facility | | $540.00 | $1,922.99 | $3,804.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.98 / $820.17 / $2,719.44
| Professional | | $375.98 | $820.17 | $2,719.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.20 / $582.66 / $1,028.17
| Facility | | $448.20 | $582.66 | $1,028.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.18 / $747.73 / $1,523.69
| Professional | | $435.18 | $747.73 | $1,523.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $572.07 / $6,679.00
| Facility | | $214.32 | $572.07 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $544.04 / $688.83 / $950.86
| Professional | | $544.04 | $688.83 | $950.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.80 / $959.66 / $1,398.14
| Professional | | $460.80 | $959.66 | $1,398.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,922.99 / $7,161.00
| Facility | | $55.00 | $1,922.99 | $7,161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $553.98 / $1,061.59 / $3,530.64
| Professional | | $553.98 | $1,061.59 | $3,530.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.00 / $2,408.00 / $5,683.00
| Facility | | $1,106.00 | $2,408.00 | $5,683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $483.20 / $758.56 / $1,318.81
| Professional | | $483.20 | $758.56 | $1,318.81 |