- 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
- $474.68 / $543.01 / $652.70
| Professional | | $474.68 | $543.01 | $652.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.00 / $559.47 / $779.46
| Professional | | $442.00 | $559.47 | $779.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.13 / $443.13 / $443.13
| Facility | | $443.13 | $443.13 | $443.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.94 / $666.50 / $1,054.15
| Professional | | $499.94 | $666.50 | $1,054.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $8,586.87
| Facility | | $55.00 | $55.00 | $8,586.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,378.40 / $3,464.64 / $4,091.70
| Professional | | $3,378.40 | $3,464.64 | $4,091.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.54 / $569.61 / $1,103.25
| Facility | | $460.54 | $569.61 | $1,103.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $604.67 / $697.71 / $814.00
| Professional | | $604.67 | $697.71 | $814.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $443.61 / $529.12 / $807.62
| Professional | | $443.61 | $529.12 | $807.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.54 / $569.61 / $1,232.23
| Facility | | $460.54 | $569.61 | $1,232.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $498.28 / $691.63 / $1,154.47
| Professional | | $498.28 | $691.63 | $1,154.47 |
- 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
- $413.44 / $546.41 / $867.99
| Professional | | $413.44 | $546.41 | $867.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.98 / $455.69 / $621.73
| Professional | | $396.98 | $455.69 | $621.73 |