- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $668.30 / $1,940.96 / $16,467.00
| Facility | | $668.30 | $1,940.96 | $16,467.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.33 / $668.30 / $922.14
| Professional | | $471.33 | $668.30 | $922.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,932.59 / $6,237.40 / $10,537.94
| Facility | | $2,932.59 | $6,237.40 | $10,537.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.92 / $646.29 / $978.03
| Professional | | $491.92 | $646.29 | $978.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $715.00 / $1,677.54
| Facility | | $715.00 | $715.00 | $1,677.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $486.99 / $796.74 / $1,497.08
| Professional | | $486.99 | $796.74 | $1,497.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.00 / $719.10 / $1,173.51
| Facility | | $446.00 | $719.10 | $1,173.51 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $669.00 / $1,074.00 / $1,923.41
| Facility | 50 | $669.00 | $1,074.00 | $1,923.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.00 / $933.00 / $1,376.31
| Professional | | $933.00 | $933.00 | $1,376.31 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $2,064.46 / $2,064.46 / $2,064.46
| Professional | 50 | $2,064.46 | $2,064.46 | $2,064.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.42 / $484.55 / $805.43
| Professional | | $69.42 | $484.55 | $805.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $10,257.00 / $16,249.00
| Facility | | $1,258.00 | $10,257.00 | $16,249.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.16 / $753.55 / $1,225.79
| Professional | | $565.16 | $753.55 | $1,225.79 |