- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.24 / $1,245.00 / $7,278.00
| Facility | | $416.24 | $1,245.00 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.36 / $422.70 / $698.80
| Professional | | $389.36 | $422.70 | $698.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.15 / $1,627.07 / $2,761.08
| Facility | | $1,479.15 | $1,627.07 | $2,761.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.52 / $653.87 / $1,021.85
| Professional | | $430.52 | $653.87 | $1,021.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $481.34 / $650.35 / $1,226.89
| Facility | | $481.34 | $650.35 | $1,226.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.42 / $589.91 / $1,061.99
| Professional | | $399.42 | $589.91 | $1,061.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.24 / $480.45 / $728.37
| Facility | | $416.24 | $480.45 | $728.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $546.00 / $1,083.31
| Professional | | $507.00 | $546.00 | $1,083.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.30 / $572.90 / $870.20
| Professional | | $478.30 | $572.90 | $870.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $1,233.00 / $4,877.00
| Facility | | $400.00 | $1,233.00 | $4,877.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.96 / $465.99 / $1,018.26
| Professional | | $343.96 | $465.99 | $1,018.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,392.67 / $3,590.15 / $16,394.00
| Facility | | $2,392.67 | $3,590.15 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,035.76 / $3,035.76 / $3,695.33
| Professional | | $3,035.76 | $3,035.76 | $3,695.33 |