- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.00 / $2,166.00 / $7,513.00
| Facility | | $569.00 | $2,166.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.76 / $589.47 / $821.78
| Professional | | $538.76 | $589.47 | $821.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,260.70 / $2,645.26 / $5,314.65
| Facility | | $1,260.70 | $2,645.26 | $5,314.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.18 / $527.21 / $608.03
| Professional | | $503.18 | $527.21 | $608.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $486.76 / $486.76 / $486.76
| Facility | | $486.76 | $486.76 | $486.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,376.10 / $2,376.10 / $2,376.10
| Facility | | $2,376.10 | $2,376.10 | $2,376.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578.55 / $755.24 / $1,149.35
| Professional | | $578.55 | $755.24 | $1,149.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $9,388.90
| Facility | | $55.00 | $55.00 | $9,388.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,059.68 / $4,150.80 / $4,619.33
| Professional | | $4,059.68 | $4,150.80 | $4,619.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.22 / $733.16 / $1,251.48
| Facility | | $540.22 | $733.16 | $1,251.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $703.08 / $827.47 / $973.49
| Professional | | $703.08 | $827.47 | $973.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $850.80 / $850.80 / $850.80
| Professional | | $850.80 | $850.80 | $850.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.22 / $746.75 / $1,412.43
| Facility | | $540.22 | $746.75 | $1,412.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.53 / $777.63 / $1,185.67
| Professional | | $583.53 | $777.63 | $1,185.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.00 / $1,529.00 / $3,287.00
| Facility | | $369.00 | $1,529.00 | $3,287.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $470.90 / $648.12 / $1,000.65
| Professional | | $470.90 | $648.12 | $1,000.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $461.58 / $530.17 / $729.55
| Professional | | $461.58 | $530.17 | $729.55 |