- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.00 / $1,181.00 / $7,439.00
| Facility | | $646.00 | $1,181.00 | $7,439.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $614.46 / $662.58 / $1,200.21
| Professional | | $614.46 | $662.58 | $1,200.21 |
- 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
- $719.27 / $927.05 / $1,641.31
| Professional | | $719.27 | $927.05 | $1,641.31 |
- 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
- $674.69 / $909.85 / $1,470.97
| Professional | | $674.69 | $909.85 | $1,470.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.00 / $803.35 / $1,288.18
| Facility | | $646.00 | $803.35 | $1,288.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $733.00 / $841.00
| Professional | | $507.00 | $733.00 | $841.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $868.90 / $1,275.40
| Professional | | $3.00 | $868.90 | $1,275.40 |
- 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
- $506.15 / $733.80 / $1,625.47
| Professional | | $506.15 | $733.80 | $1,625.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,413.64 / $4,754.80 / $16,394.00
| Facility | | $2,413.64 | $4,754.80 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,692.72 / $4,692.72 / $5,583.68
| Professional | | $4,692.72 | $4,692.72 | $5,583.68 |