- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.00 / $1,350.00 / $1,828.56
| Facility | | $420.00 | $1,350.00 | $1,828.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.00 / $450.00 / $924.00
| Professional | | $399.00 | $450.00 | $924.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.32 / $686.13 / $1,878.60
| Facility | | $443.32 | $686.13 | $1,878.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.00 / $600.70 / $2,379.38
| Professional | | $360.00 | $600.70 | $2,379.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $856.49 / $1,316.20 / $2,384.42
| Facility | | $856.49 | $1,316.20 | $2,384.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $564.00 / $564.00 / $564.00
| Professional | | $564.00 | $564.00 | $564.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.00 / $468.00 / $1,365.00
| Facility | | $390.00 | $468.00 | $1,365.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.06 / $633.09 / $1,564.33
| Professional | | $312.06 | $633.09 | $1,564.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,472.00 / $9,239.00
| Facility | | $83.43 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $865.82 / $865.82 / $1,018.61
| Professional | | $865.82 | $865.82 | $1,018.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $600.00 / $600.00 / $1,858.14
| Professional | | $600.00 | $600.00 | $1,858.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,044.00 / $2,850.00 / $2,850.00
| Facility | | $1,044.00 | $2,850.00 | $2,850.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.00 / $360.00 / $3,000.00
| Professional | | $360.00 | $360.00 | $3,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.00 / $600.00 / $1,300.21
| Professional | | $360.00 | $600.00 | $1,300.21 |