- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.00 / $2,172.00 / $7,513.00
| Facility | | $569.00 | $2,172.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.01 / $560.74 / $774.07
| Professional | | $485.01 | $560.74 | $774.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.75 / $497.43 / $573.67
| Professional | | $474.75 | $497.43 | $573.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.60 / $472.60 / $472.60
| Facility | | $472.60 | $472.60 | $472.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.33 / $703.31 / $1,093.55
| Professional | | $540.33 | $703.31 | $1,093.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $4,212.53
| Facility | | $55.00 | $55.00 | $4,212.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,837.28 / $3,925.84 / $4,390.88
| Professional | | $3,837.28 | $3,925.84 | $4,390.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.41 / $666.47 / $1,240.00
| Facility | | $518.41 | $666.47 | $1,240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $666.08 / $783.93 / $922.27
| Professional | | $666.08 | $783.93 | $922.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $725.80 / $725.80 / $725.80
| Professional | | $725.80 | $725.80 | $725.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.41 / $673.95 / $1,330.91
| Facility | | $518.41 | $673.95 | $1,330.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $540.52 / $712.47 / $1,150.82
| Professional | | $540.52 | $712.47 | $1,150.82 |
- 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
- $435.10 / $596.41 / $924.58
| Professional | | $435.10 | $596.41 | $924.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $437.29 / $499.40 / $692.10
| Professional | | $437.29 | $499.40 | $692.10 |