- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $3,596.00 / $10,836.00
| Facility | | $657.00 | $3,596.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.00 / $520.85 / $627.09
| Professional | | $456.00 | $520.85 | $627.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.84 / $536.48 / $738.49
| Professional | | $423.84 | $536.48 | $738.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.10 / $425.10 / $425.10
| Facility | | $425.10 | $425.10 | $425.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.19 / $649.41 / $1,049.34
| Professional | | $479.19 | $649.41 | $1,049.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $5,670.94
| Facility | | $55.00 | $55.00 | $5,670.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,243.68 / $3,320.88 / $3,935.70
| Professional | | $3,243.68 | $3,320.88 | $3,935.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.51 / $547.38 / $1,057.41
| Facility | | $442.51 | $547.38 | $1,057.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $581.14 / $670.55 / $782.30
| Professional | | $581.14 | $670.55 | $782.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.56 / $507.59 / $775.55
| Professional | | $425.56 | $507.59 | $775.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.51 / $547.38 / $1,181.59
| Facility | | $442.51 | $547.38 | $1,181.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $479.19 / $655.52 / $1,148.66
| Professional | | $479.19 | $655.52 | $1,148.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $2,064.00 / $8,759.00
| Facility | | $385.00 | $2,064.00 | $8,759.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.12 / $519.91 / $831.63
| Professional | | $396.12 | $519.91 | $831.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.53 / $437.90 / $597.39
| Professional | | $381.53 | $437.90 | $597.39 |