- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,747.00 / $8,017.00
| Facility | | $832.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.99 / $483.35 / $573.50
| Professional | | $399.99 | $483.35 | $573.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $453.21 / $470.32 / $470.32
| Professional | | $453.21 | $470.32 | $470.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.52 / $585.42 / $918.31
| Professional | | $437.52 | $585.42 | $918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.94 / $701.14 / $706.27
| Professional | | $529.94 | $701.14 | $706.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.00 / $3,120.00 / $8,017.00
| Facility | | $934.00 | $3,120.00 | $8,017.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.99 / $487.91 / $2,384.92
| Professional | | $399.99 | $487.91 | $2,384.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $587.50 / $1,129.20
| Professional | | $3.00 | $587.50 | $1,129.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.96 / $591.30 / $929.65
| Professional | | $438.96 | $591.30 | $929.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.52 / $439.52 / $500.57
| Facility | | $439.52 | $439.52 | $500.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.91 / $440.92 / $500.57
| Professional | | $426.91 | $440.92 | $500.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,447.00 / $3,311.00 / $6,000.00
| Facility | | $1,447.00 | $3,311.00 | $6,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.55 / $556.38 / $905.62
| Professional | | $437.55 | $556.38 | $905.62 |