- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.97 / $2,747.00 / $4,806.64
| Facility | | $485.97 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.33 / $519.88 / $875.07
| Professional | | $425.33 | $519.88 | $875.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.01 / $966.90 / $2,713.00
| Facility | | $464.01 | $966.90 | $2,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.96 / $847.02 / $3,283.39
| Professional | | $427.96 | $847.02 | $3,283.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.34 / $640.37 / $1,143.19
| Facility | | $498.34 | $640.37 | $1,143.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $551.16 / $819.77 / $1,107.06
| Professional | | $551.16 | $819.77 | $1,107.06 |
- 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
- $487.88 / $798.52 / $1,274.68
| Professional | | $487.88 | $798.52 | $1,274.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $681.51 / $8,090.00
| Facility | | $300.00 | $681.51 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.63 / $590.67 / $810.53
| Professional | | $487.63 | $590.67 | $810.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $521.41 / $989.94 / $1,314.96
| Professional | | $521.41 | $989.94 | $1,314.96 |
- 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
- $514.64 / $945.67 / $3,283.39
| Professional | | $514.64 | $945.67 | $3,283.39 |
- 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
- $493.98 / $733.08 / $1,378.84
| Professional | | $493.98 | $733.08 | $1,378.84 |