- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.39 / $4,771.00 / $9,539.00
| Facility | | $585.39 | $4,771.00 | $9,539.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.49 / $585.39 / $817.00
| Professional | | $487.49 | $585.39 | $817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,060.00 / $3,693.00 / $4,290.00
| Facility | | $3,060.00 | $3,693.00 | $4,290.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.17 / $576.97 / $804.19
| Professional | | $453.17 | $576.97 | $804.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $545.74 / $673.01 / $1,312.37
| Professional | | $545.74 | $673.01 | $1,312.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.17 / $692.15 / $1,169.86
| Professional | | $505.17 | $692.15 | $1,169.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.57 / $558.67 / $689.04
| Professional | | $465.57 | $558.67 | $689.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.26 / $664.83 / $956.91
| Facility | | $532.26 | $664.83 | $956.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $649.00 / $721.00 / $1,286.00
| Professional | | $649.00 | $721.00 | $1,286.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.72 / $722.46 / $3,658.00
| Facility | | $536.72 | $722.46 | $3,658.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $536.72 / $722.46 / $3,658.00
| Professional | | $536.72 | $722.46 | $3,658.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $3,130.00 / $5,226.00
| Facility | | $1,547.00 | $3,130.00 | $5,226.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $470.26 / $785.66 / $1,115.47
| Professional | | $470.26 | $785.66 | $1,115.47 |