- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.85 / $3,599.10 / $7,702.70
| Facility | | $616.85 | $3,599.10 | $7,702.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.95 / $578.88 / $1,708.01
| Professional | | $274.95 | $578.88 | $1,708.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.83 / $453.67 / $935.20
| Professional | | $226.83 | $453.67 | $935.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,326.31 / $1,326.31 / $1,345.66
| Facility | | $1,326.31 | $1,326.31 | $1,345.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $365.68 / $704.70 / $1,474.53
| Professional | | $365.68 | $704.70 | $1,474.53 |
- 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
- $325.12 / $659.55 / $1,220.56
| Professional | | $325.12 | $659.55 | $1,220.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.13 / $581.94 / $998.47
| Facility | | $288.13 | $581.94 | $998.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $688.00 / $753.00
| Professional | | $507.00 | $688.00 | $753.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,120.85 / $2,120.85 / $2,120.85
| Facility | | $2,120.85 | $2,120.85 | $2,120.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.75 / $727.22 / $987.38
| Professional | | $400.75 | $727.22 | $987.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.99 / $692.45 / $1,301.08
| Professional | | $469.99 | $692.45 | $1,301.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,377.64 / $1,550.35 / $16,394.00
| Facility | | $1,377.64 | $1,550.35 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,523.00 / $4,196.47 / $4,976.47
| Professional | | $2,523.00 | $4,196.47 | $4,976.47 |