- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $236.35 / $1,579.73 / $7,278.00
| Facility | | $236.35 | $1,579.73 | $7,278.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.47 / $496.85 / $1,328.94
| Professional | | $229.47 | $496.85 | $1,328.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $373.64 / $373.64 / $373.64
| Professional | | $373.64 | $373.64 | $373.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $384.32 / $1,077.01 / $1,917.81
| Professional | | $384.32 | $1,077.01 | $1,917.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.91 / $650.35 / $1,226.89
| Facility | | $395.91 | $650.35 | $1,226.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.64 / $787.28 / $1,903.46
| Professional | | $287.64 | $787.28 | $1,903.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.47 / $834.83 / $1,086.20
| Facility | | $229.47 | $834.83 | $1,086.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.00 / $708.93 / $1,968.39
| Professional | | $400.00 | $708.93 | $1,968.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.56 / $678.90 / $1,845.30
| Professional | | $271.56 | $678.90 | $1,845.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.08 / $883.38 / $1,822.17
| Professional | | $496.08 | $883.38 | $1,822.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,329.67 / $1,329.67
| Facility | | $55.00 | $1,329.67 | $1,329.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,981.48 / $5,677.60 / $6,687.30
| Professional | | $2,981.48 | $5,677.60 | $6,687.30 |