- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.00 / $2,166.00 / $7,513.00
| Facility | | $521.00 | $2,166.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $401.12 / $479.69 / $763.34
| Professional | | $401.12 | $479.69 | $763.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.77 / $435.86 / $966.47
| Facility | | $251.77 | $435.86 | $966.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.06 / $662.00 / $993.93
| Professional | | $475.06 | $662.00 | $993.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.89 / $451.89 / $451.89
| Facility | | $451.89 | $451.89 | $451.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.09 / $234.09 / $234.09
| Facility | | $234.09 | $234.09 | $234.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.33 / $675.28 / $974.11
| Professional | | $491.33 | $675.28 | $974.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $4,049.71
| Facility | | $55.00 | $55.00 | $4,049.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,598.32 / $3,699.44 / $4,523.85
| Professional | | $3,598.32 | $3,699.44 | $4,523.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.83 / $616.51 / $1,150.63
| Facility | | $471.83 | $616.51 | $1,150.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $555.78 / $773.03 / $909.45
| Professional | | $555.78 | $773.03 | $909.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $483.22 / $619.10 / $1,177.77
| Facility | | $483.22 | $619.10 | $1,177.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $499.07 / $693.47 / $1,076.86
| Professional | | $499.07 | $693.47 | $1,076.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $950.00 / $2,376.00
| Facility | | $157.00 | $950.00 | $2,376.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.06 / $556.28 / $896.95
| Professional | | $407.06 | $556.28 | $896.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.22 / $492.48 / $672.88
| Professional | | $431.22 | $492.48 | $672.88 |