- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.99 / $2,079.00 / $3,625.00
| Facility | | $571.99 | $2,079.00 | $3,625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.07 / $611.66 / $1,382.65
| Professional | | $524.07 | $611.66 | $1,382.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $736.00 / $1,999.64 / $4,142.00
| Facility | | $736.00 | $1,999.64 | $4,142.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $608.76 / $1,175.00 / $4,614.16
| Professional | | $608.76 | $1,175.00 | $4,614.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.42 / $902.61 / $1,611.35
| Facility | | $702.42 | $902.61 | $1,611.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $817.37 / $1,180.63 / $1,676.12
| Professional | | $817.37 | $1,180.63 | $1,676.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $622.17 / $1,020.85 / $1,777.39
| Professional | | $622.17 | $1,020.85 | $1,777.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $589.28 / $1,280.80 / $6,679.00
| Facility | | $589.28 | $1,280.80 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $739.22 / $895.50 / $1,236.14
| Professional | | $739.22 | $895.50 | $1,236.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $730.32 / $1,470.86 / $1,982.14
| Professional | | $730.32 | $1,470.86 | $1,982.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.98 / $586.98 / $3,399.38
| Facility | | $586.98 | $586.98 | $3,399.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $330.67 / $330.67 / $330.67
| Professional | | $330.67 | $330.67 | $330.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $2,217.00 / $12,000.00
| Facility | | $627.00 | $2,217.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $685.08 / $1,336.83 / $4,614.16
| Professional | | $685.08 | $1,336.83 | $4,614.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $3,445.00
| Facility | | $627.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $640.23 / $998.75 / $2,056.26
| Professional | | $640.23 | $998.75 | $2,056.26 |