- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.28 / $1,181.00 / $7,278.00
| Facility | | $384.28 | $1,181.00 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.56 / $501.07 / $871.40
| Professional | | $361.56 | $501.07 | $871.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.49 / $316.49 / $449.56
| Professional | | $316.49 | $316.49 | $449.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,585.61 / $1,585.61 / $1,608.75
| Facility | | $1,585.61 | $1,585.61 | $1,608.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.97 / $743.42 / $1,285.04
| Professional | | $474.97 | $743.42 | $1,285.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,062.80
| Facility | | $530.04 | $530.04 | $2,062.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.05 / $656.51 / $1,157.18
| Professional | | $432.05 | $656.51 | $1,157.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.28 / $629.71 / $1,328.00
| Facility | | $384.28 | $629.71 | $1,328.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $655.00 / $669.00
| Professional | | $507.00 | $655.00 | $669.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $688.73 / $1,458.50
| Professional | | $3.00 | $688.73 | $1,458.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.16 / $636.24 / $1,411.71
| Professional | | $445.16 | $636.24 | $1,411.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,791.88 / $1,981.04 / $16,394.00
| Facility | | $1,791.88 | $1,981.04 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,829.76 / $4,415.85 / $4,825.49
| Professional | | $2,829.76 | $4,415.85 | $4,825.49 |