- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.45 / $2,747.00 / $4,806.64
| Facility | | $319.45 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.27 / $380.03 / $615.57
| Professional | | $319.27 | $380.03 | $615.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.10 / $947.00 / $2,713.00
| Facility | | $448.10 | $947.00 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.60 / $754.19 / $3,142.48
| Professional | | $368.60 | $754.19 | $3,142.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.01 / $616.80 / $1,101.14
| Facility | | $480.01 | $616.80 | $1,101.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $50.00 / $50.00
| Facility | | $50.00 | $50.00 | $50.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.64 / $661.73 / $1,140.67
| Professional | | $402.64 | $661.73 | $1,140.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $612.66 / $6,679.00
| Facility | | $214.32 | $612.66 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.62 / $615.72 / $849.94
| Professional | | $505.62 | $615.72 | $849.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.57 / $987.14 / $1,275.04
| Professional | | $493.57 | $987.14 | $1,275.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $747.01 / $747.01 / $747.01
| Professional | | $747.01 | $747.01 | $747.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,818.00 / $3,445.00
| Facility | | $55.00 | $1,818.00 | $3,445.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.16 / $807.62 / $3,142.48
| Professional | | $410.16 | $807.62 | $3,142.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $2,733.00
| Facility | | $627.00 | $1,818.00 | $2,733.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.99 / $659.53 / $1,290.73
| Professional | | $396.99 | $659.53 | $1,290.73 |