- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.25 / $1,181.00 / $7,439.00
| Facility | | $444.25 | $1,181.00 | $7,439.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.24 / $444.25 / $834.92
| Professional | | $383.24 | $444.25 | $834.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.44 / $663.48 / $1,184.23
| Professional | | $370.44 | $663.48 | $1,184.23 |
- 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
- $466.00 / $637.45 / $1,114.86
| Professional | | $466.00 | $637.45 | $1,114.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.25 / $584.40 / $1,004.01
| Facility | | $444.25 | $584.40 | $1,004.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $462.00 / $462.00 / $600.00
| Professional | | $462.00 | $462.00 | $600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $611.10 / $1,016.10
| Professional | | $3.00 | $611.10 | $1,016.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.36 / $533.40 / $1,192.33
| Professional | | $369.36 | $533.40 | $1,192.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,726.12 / $8,957.00 / $16,394.00
| Facility | | $1,726.12 | $8,957.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,980.55 / $4,578.92 / $4,578.92
| Professional | | $3,980.55 | $4,578.92 | $4,578.92 |