- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $654.03 / $2,747.00 / $4,806.64
| Facility | | $654.03 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.62 / $654.03 / $1,266.58
| Professional | | $290.62 | $654.03 | $1,266.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $953.00 / $7,231.00
| Facility | | $55.00 | $953.00 | $7,231.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.95 / $563.78 / $16,280.00
| Professional | | $319.95 | $563.78 | $16,280.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.01 / $710.66 / $939.92
| Professional | | $486.01 | $710.66 | $939.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $680.00 / $748.00
| Facility | | $50.00 | $680.00 | $748.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.31 / $756.29 / $1,370.69
| Professional | | $436.31 | $756.29 | $1,370.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $655.56 / $8,090.00
| Facility | | $300.00 | $655.56 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.98 / $473.64 / $698.17
| Professional | | $364.98 | $473.64 | $698.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $495.62 / $940.19 / $1,138.93
| Professional | | $495.62 | $940.19 | $1,138.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,845.00 / $16,280.00
| Facility | | $55.00 | $1,845.00 | $16,280.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.18 / $568.76 / $16,280.00
| Professional | | $331.18 | $568.76 | $16,280.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $2,446.00 / $4,050.00
| Facility | | $789.00 | $2,446.00 | $4,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.86 / $566.60 / $1,234.39
| Professional | | $332.86 | $566.60 | $1,234.39 |