- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.83 / $1,181.00 / $7,439.00
| Facility | | $438.83 | $1,181.00 | $7,439.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.95 / $462.10 / $825.97
| Professional | | $403.95 | $462.10 | $825.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,223.35 / $1,223.35 / $1,748.03
| Facility | | $1,223.35 | $1,223.35 | $1,748.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.11 / $666.40 / $1,166.06
| Professional | | $416.11 | $666.40 | $1,166.06 |
- 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
- $463.78 / $607.61 / $1,085.04
| Professional | | $463.78 | $607.61 | $1,085.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.83 / $543.00 / $876.42
| Facility | | $438.83 | $543.00 | $876.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $545.00 / $600.00
| Professional | | $507.00 | $545.00 | $600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $707.42 / $1,174.40
| Professional | | $3.00 | $707.42 | $1,174.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,064.00 / $3,456.00 / $5,919.00
| Facility | | $1,064.00 | $3,456.00 | $5,919.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.24 / $528.01 / $1,043.33
| Professional | | $372.24 | $528.01 | $1,043.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,706.44 / $8,957.00 / $16,394.00
| Facility | | $1,706.44 | $8,957.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,332.48 / $3,332.48 / $3,918.90
| Professional | | $3,332.48 | $3,332.48 | $3,918.90 |