- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.47 / $303.00 / $1,357.98
| Facility | | $153.47 | $303.00 | $1,357.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.99 / $565.69 / $1,052.70
| Professional | | $129.99 | $565.69 | $1,052.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.45 / $648.88 / $1,195.56
| Facility | | $314.45 | $648.88 | $1,195.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.22 / $1,182.72 / $5,036.20
| Professional | | $188.22 | $1,182.72 | $5,036.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.72 / $484.78 / $640.42
| Facility | | $158.72 | $484.78 | $640.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.04 / $663.19 / $840.77
| Facility | | $199.04 | $663.19 | $840.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.91 / $479.81 / $2,076.19
| Professional | | $164.91 | $479.81 | $2,076.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.38 / $289.42 / $6,679.00
| Facility | | $137.38 | $289.42 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.24 / $801.20 / $1,323.15
| Professional | | $446.24 | $801.20 | $1,323.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.75 / $570.28 / $1,947.83
| Professional | | $195.75 | $570.28 | $1,947.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,195.56 / $1,195.56 / $1,195.56
| Facility | | $1,195.56 | $1,195.56 | $1,195.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $629.10 / $1,888.79 / $5,036.20
| Professional | | $629.10 | $1,888.79 | $5,036.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $567.36 / $1,182.72 / $2,174.60
| Professional | | $567.36 | $1,182.72 | $2,174.60 |