- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.92 / $962.13 / $8,413.00
| Facility | | $669.92 | $962.13 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $669.92 / $702.68 / $1,246.42
| Professional | | $669.92 | $702.68 | $1,246.42 |
- 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
- $499.43 / $1,037.93 / $1,755.20
| Professional | | $499.43 | $1,037.93 | $1,755.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $700.90 / $984.09 / $1,539.83
| Professional | | $700.90 | $984.09 | $1,539.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.92 / $846.96 / $1,375.92
| Facility | | $669.92 | $846.96 | $1,375.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.00 / $771.00 / $874.00
| Professional | | $579.00 | $771.00 | $874.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $899.20 / $1,673.10
| Professional | | $3.00 | $899.20 | $1,673.10 |
- 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
- $538.19 / $778.93 / $1,574.42
| Professional | | $538.19 | $778.93 | $1,574.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,499.76 / $8,957.00 / $26,542.00
| Facility | | $2,499.76 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,888.64 / $4,888.64 / $5,759.70
| Professional | | $4,888.64 | $4,888.64 | $5,759.70 |