- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.12 / $1,020.00 / $7,724.00
| Facility | | $325.12 | $1,020.00 | $7,724.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.02 / $453.97 / $761.61
| Professional | | $313.02 | $453.97 | $761.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,426.56 / $1,426.56 / $2,038.38
| Facility | | $1,426.56 | $1,426.56 | $2,038.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.83 / $664.86 / $1,182.40
| Professional | | $295.83 | $664.86 | $1,182.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.97 / $569.54 / $1,043.57
| Professional | | $390.97 | $569.54 | $1,043.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.62 / $566.65 / $869.00
| Facility | | $331.62 | $566.65 | $869.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $567.63 / $619.00 / $625.00
| Professional | | $567.63 | $619.00 | $625.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $639.90 / $1,324.40
| Professional | | $3.00 | $639.90 | $1,324.40 |
- 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
- $413.28 / $574.37 / $1,297.41
| Professional | | $413.28 | $574.37 | $1,297.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,560.48 / $1,724.73 / $26,542.00
| Facility | | $1,560.48 | $1,724.73 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,486.08 / $3,521.60 / $4,062.90
| Professional | | $2,486.08 | $3,521.60 | $4,062.90 |