- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $583.97 / $3,743.31 / $7,439.00
| Facility | | $583.97 | $3,743.31 | $7,439.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.56 / $548.21 / $1,195.09
| Professional | | $393.56 | $548.21 | $1,195.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.84 / $565.98 / $711.04
| Professional | | $358.84 | $565.98 | $711.04 |
- 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
- $483.48 / $733.96 / $1,315.41
| Professional | | $483.48 | $733.96 | $1,315.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.00 / $723.47 / $1,226.89
| Facility | | $515.00 | $723.47 | $1,226.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.14 / $678.23 / $1,239.71
| Professional | | $426.14 | $678.23 | $1,239.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.82 / $593.00 / $913.28
| Facility | | $417.82 | $593.00 | $913.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.00 / $611.00 / $786.67
| Professional | | $579.00 | $611.00 | $786.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.80 / $648.42 / $1,177.20
| Professional | | $435.80 | $648.42 | $1,177.20 |
- 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
- $431.22 / $602.47 / $1,426.81
| Professional | | $431.22 | $602.47 | $1,426.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,954.10 / $2,954.10 / $26,542.00
| Facility | | $2,954.10 | $2,954.10 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,094.32 / $4,003.28 / $4,777.13
| Professional | | $3,094.32 | $4,003.28 | $4,777.13 |