- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.20 / $672.85 / $7,278.00
| Facility | | $299.20 | $672.85 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.06 / $457.43 / $825.20
| Professional | | $295.06 | $457.43 | $825.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,311.30 / $1,311.30 / $1,330.43
| Facility | | $1,311.30 | $1,311.30 | $1,330.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $408.88 / $676.94 / $1,131.66
| Professional | | $408.88 | $676.94 | $1,131.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,215.60
| Facility | | $530.04 | $530.04 | $1,215.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.93 / $576.58 / $1,018.66
| Professional | | $389.93 | $576.58 | $1,018.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.18 / $526.22 / $1,080.00
| Facility | | $305.18 | $526.22 | $1,080.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $559.00 / $620.00
| Professional | | $507.00 | $559.00 | $620.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $640.20 / $1,208.09
| Professional | | $3.00 | $640.20 | $1,208.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $391.21 / $572.42 / $1,307.40
| Professional | | $391.21 | $572.42 | $1,307.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,416.76 / $1,568.69 / $16,394.00
| Facility | | $1,416.76 | $1,568.69 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,230.80 / $3,903.64 / $4,104.60
| Professional | | $2,230.80 | $3,903.64 | $4,104.60 |