- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $807.99 / $1,181.00 / $7,439.00
| Facility | | $807.99 | $1,181.00 | $7,439.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $768.59 / $840.27 / $1,502.92
| Professional | | $768.59 | $840.27 | $1,502.92 |
- 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
- $841.98 / $1,136.18 / $2,006.38
| Professional | | $841.98 | $1,136.18 | $2,006.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $803.13 / $1,073.75 / $1,856.18
| Professional | | $803.13 | $1,073.75 | $1,856.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $807.99 / $914.34 / $1,528.36
| Facility | | $807.99 | $914.34 | $1,528.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $930.00 / $1,058.00
| Professional | | $507.00 | $930.00 | $1,058.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $1,083.80 / $1,999.80
| Professional | | $3.00 | $1,083.80 | $1,999.80 |
- 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
- $651.91 / $939.89 / $2,057.30
| Professional | | $651.91 | $939.89 | $2,057.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,051.56 / $8,957.00 / $16,394.00
| Facility | | $3,051.56 | $8,957.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,909.20 / $5,909.20 / $7,041.38
| Professional | | $5,909.20 | $5,909.20 | $7,041.38 |