- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.00 / $2,514.00 / $7,495.00
| Facility | | $569.00 | $2,514.00 | $7,495.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.50 / $512.29 / $687.21
| Professional | | $358.50 | $512.29 | $687.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,964.47 / $3,928.93 / $7,936.45
| Facility | | $1,964.47 | $3,928.93 | $7,936.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.43 / $489.09 / $705.36
| Professional | | $343.43 | $489.09 | $705.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $324.18 / $324.18 / $509.90
| Facility | | $324.18 | $324.18 | $509.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.80 / $550.57 / $789.77
| Professional | | $383.80 | $550.57 | $789.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,569.44 / $16,394.00 / $16,394.00
| Facility | | $2,569.44 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,019.00 / $3,808.80 / $4,450.95
| Professional | | $3,019.00 | $3,808.80 | $4,450.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.06 / $512.42 / $762.18
| Facility | | $354.06 | $512.42 | $762.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $455.69 / $678.06 / $954.81
| Professional | | $455.69 | $678.06 | $954.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.33 / $512.54 / $772.06
| Facility | | $354.33 | $512.54 | $772.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.86 / $580.12 / $943.83
| Professional | | $393.86 | $580.12 | $943.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $2,064.00 / $4,554.00
| Facility | | $597.00 | $2,064.00 | $4,554.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.16 / $530.88 / $783.05
| Professional | | $398.16 | $530.88 | $783.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.12 / $492.84 / $689.98
| Professional | | $438.12 | $492.84 | $689.98 |