- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,780.69 / $2,837.76 / $5,667.57
| Facility | | $1,780.69 | $2,837.76 | $5,667.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,488.34 / $1,743.48 / $2,126.19
| Professional | | $1,488.34 | $1,743.48 | $2,126.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $3,120.20 / $8,292.18
| Facility | | $244.00 | $3,120.20 | $8,292.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.92 / $61.38 / $107.21
| Facility | | $22.92 | $61.38 | $107.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,487.65 / $2,976.68 / $3,763.37
| Facility | | $2,487.65 | $2,976.68 | $3,763.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,275.72 / $1,275.72 / $1,807.27
| Professional | | $1,275.72 | $1,275.72 | $1,807.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,126.19 / $2,126.19 / $3,231.82
| Professional | | $2,126.19 | $2,126.19 | $3,231.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $967.42 / $1,382.03 / $3,455.77
| Professional | | $967.42 | $1,382.03 | $3,455.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.28 / $14.34 / $1,507.47
| Professional | | $13.28 | $14.34 | $1,507.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,637.01 / $3,297.91 / $6,611.73
| Facility | | $1,637.01 | $3,297.91 | $6,611.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,552.49 / $2,589.91 / $3,103.00
| Professional | | $2,552.49 | $2,589.91 | $3,103.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.72 / $2,019.88 / $2,551.44
| Facility | | $1,275.72 | $2,019.88 | $2,551.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $893.00 / $1,275.72 / $2,404.73
| Professional | | $893.00 | $1,275.72 | $2,404.73 |