- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.73 / $371.78 / $845.20
| Facility | | $283.73 | $371.78 | $845.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.62 / $903.19 / $1,858.00
| Professional | | $316.62 | $903.19 | $1,858.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.40 / $1,759.00 / $4,050.00
| Facility | | $472.40 | $1,759.00 | $4,050.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.85 / $991.62 / $3,964.16
| Professional | | $456.85 | $991.62 | $3,964.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $487.26 / $633.44 / $1,117.77
| Facility | | $487.26 | $633.44 | $1,117.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $580.33 / $874.58 / $1,377.48
| Professional | | $580.33 | $874.58 | $1,377.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $497.86 / $961.10 / $1,564.82
| Professional | | $497.86 | $961.10 | $1,564.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $666.35 / $8,090.00
| Facility | | $300.00 | $666.35 | $8,090.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.44 / $634.33 / $1,000.83
| Professional | | $342.44 | $634.33 | $1,000.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.63 / $1,152.47 / $1,596.37
| Professional | | $546.63 | $1,152.47 | $1,596.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $566.21 / $871.32 / $1,748.38
| Professional | | $566.21 | $871.32 | $1,748.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,078.00 / $5,876.00
| Facility | | $55.00 | $2,078.00 | $5,876.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.26 / $1,279.86 / $3,964.16
| Professional | | $501.26 | $1,279.86 | $3,964.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $3,325.00 / $4,662.00
| Facility | | $953.00 | $3,325.00 | $4,662.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.81 / $838.36 / $1,836.84
| Professional | | $482.81 | $838.36 | $1,836.84 |