- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.00 / $3,570.00 / $10,836.00
| Facility | | $969.00 | $3,570.00 | $10,836.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.82 / $1,092.73 / $1,532.91
| Professional | | $954.82 | $1,092.73 | $1,532.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $996.96 / $1,261.91 / $1,758.13
| Professional | | $996.96 | $1,261.91 | $1,758.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.10 / $977.10 / $977.10
| Facility | | $977.10 | $977.10 | $977.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,079.99 / $1,448.76 / $2,223.75
| Professional | | $1,079.99 | $1,448.76 | $2,223.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $8,618.82
| Facility | | $55.00 | $55.00 | $8,618.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7,829.92 / $8,054.08 / $9,035.85
| Professional | | $7,829.92 | $8,054.08 | $9,035.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,021.94 / $1,343.66 / $2,289.03
| Facility | | $1,021.94 | $1,343.66 | $2,289.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,154.97 / $1,606.45 / $1,889.95
| Professional | | $1,154.97 | $1,606.45 | $1,889.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,298.00 / $1,298.00 / $1,298.00
| Professional | | $1,298.00 | $1,298.00 | $1,298.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.03 / $1,343.66 / $2,343.01
| Facility | | $1,030.03 | $1,343.66 | $2,343.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,079.99 / $1,471.89 / $2,332.73
| Professional | | $1,079.99 | $1,471.89 | $2,332.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $2,064.00 / $8,759.00
| Facility | | $385.00 | $2,064.00 | $8,759.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $862.56 / $1,180.50 / $1,851.93
| Professional | | $862.56 | $1,180.50 | $1,851.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $896.12 / $1,021.94 / $1,417.27
| Professional | | $896.12 | $1,021.94 | $1,417.27 |