- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.31 / $2,288.96 / $8,413.00
| Facility | | $460.31 | $2,288.96 | $8,413.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.89 / $490.10 / $1,106.40
| Professional | | $434.89 | $490.10 | $1,106.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.89 / $1,794.89 / $1,821.08
| Facility | | $1,794.89 | $1,794.89 | $1,821.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.37 / $845.77 / $1,308.11
| Professional | | $475.37 | $845.77 | $1,308.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,062.80
| Facility | | $606.10 | $606.10 | $2,062.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.09 / $685.87 / $1,188.60
| Professional | | $518.09 | $685.87 | $1,188.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.31 / $594.48 / $869.97
| Facility | | $460.31 | $594.48 | $869.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $586.00 / $586.00 / $605.00
| Professional | | $586.00 | $586.00 | $605.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $614.60 / $1,250.50
| Professional | | $5.00 | $614.60 | $1,250.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,711.00 / $7,162.00 / $10,397.00
| Facility | | $1,711.00 | $7,162.00 | $10,397.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.28 / $587.69 / $1,139.66
| Professional | | $416.28 | $587.69 | $1,139.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $5,950.27 / $6,817.20
| Facility | | $55.00 | $5,950.27 | $6,817.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,374.72 / $4,082.70 / $4,082.70
| Professional | | $3,374.72 | $4,082.70 | $4,082.70 |