- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.48 / $1,181.00 / $7,439.00
| Facility | | $361.48 | $1,181.00 | $7,439.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.48 / $380.50 / $678.38
| Professional | | $361.48 | $380.50 | $678.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.55 / $1,703.55 / $1,728.40
| Facility | | $1,703.55 | $1,703.55 | $1,728.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $460.73 / $632.41 / $996.82
| Professional | | $460.73 | $632.41 | $996.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,438.74
| Facility | | $530.04 | $530.04 | $1,438.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.63 / $586.75 / $907.33
| Professional | | $400.63 | $586.75 | $907.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.48 / $487.72 / $816.94
| Facility | | $361.48 | $487.72 | $816.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.00 / $450.00 / $600.00
| Professional | | $450.00 | $450.00 | $600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $499.20 / $984.50
| Professional | | $3.00 | $499.20 | $984.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.67 / $499.68 / $989.35
| Professional | | $322.67 | $499.68 | $989.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,406.24 / $4,754.80 / $16,394.00
| Facility | | $1,406.24 | $4,754.80 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,243.53 / $3,344.07 / $3,344.07
| Professional | | $3,243.53 | $3,344.07 | $3,344.07 |