- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,339.89 / $4,582.07 / $8,077.38
| Facility | | $1,339.89 | $4,582.07 | $8,077.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,017.08 / $1,050.90 / $1,108.35
| Professional | | $1,017.08 | $1,050.90 | $1,108.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $614.00 / $5,601.03
| Facility | | $244.00 | $614.00 | $5,601.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.83 / $346.60 / $749.73
| Professional | | $288.83 | $346.60 | $749.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $1,475.73 / $10,028.28
| Facility | | $59.40 | $1,475.73 | $10,028.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $593.29 / $847.57 / $2,130.71
| Professional | | $593.29 | $847.57 | $2,130.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $839.09 / $1,750.23 / $4,267.51
| Facility | | $839.09 | $1,750.23 | $4,267.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,303.95 / $1,564.74 / $2,086.32
| Professional | | $1,303.95 | $1,564.74 | $2,086.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,173.56 / $1,499.54 / $2,842.61
| Professional | | $1,173.56 | $1,499.54 | $2,842.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,268.87 / $6,193.76 / $6,193.76
| Facility | | $2,268.87 | $6,193.76 | $6,193.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,493.67 / $6,493.67 / $9,779.62
| Professional | | $6,493.67 | $6,493.67 | $9,779.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $926.07 / $1,564.74 / $3,416.45
| Facility | | $926.07 | $1,564.74 | $3,416.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,303.95 / $1,434.35 / $1,955.93
| Professional | | $1,303.95 | $1,434.35 | $1,955.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,117.98 / $1,117.98 / $1,117.98
| Professional | | $1,117.98 | $1,117.98 | $1,117.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.55 / $508.68 / $2,360.15
| Professional | | $469.55 | $508.68 | $2,360.15 |