- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.74 / $1,181.00 / $7,439.00
| Facility | | $439.74 | $1,181.00 | $7,439.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.74 / $462.76 / $884.40
| Professional | | $439.74 | $462.76 | $884.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,457.61 / $1,457.61 / $1,478.88
| Facility | | $1,457.61 | $1,457.61 | $1,478.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.45 / $726.17 / $1,236.25
| Professional | | $448.45 | $726.17 | $1,236.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,587.44
| Facility | | $530.04 | $530.04 | $1,587.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.20 / $650.72 / $1,148.03
| Professional | | $485.20 | $650.72 | $1,148.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.74 / $596.21 / $908.19
| Facility | | $439.74 | $596.21 | $908.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $574.00 / $600.00
| Professional | | $507.00 | $574.00 | $600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $589.00 / $1,336.90
| Professional | | $5.00 | $589.00 | $1,336.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.62 / $584.22 / $1,079.44
| Professional | | $398.62 | $584.22 | $1,079.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,494.26 / $5,246.20 / $16,394.00
| Facility | | $2,494.26 | $5,246.20 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,951.10 / $3,951.10 / $3,951.10
| Professional | | $3,951.10 | $3,951.10 | $3,951.10 |