- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $7,079.46 / $8,709.64
| Facility | | $64.57 | $7,079.46 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $234.42 / $6,918.31
| Professional | | $54.95 | $234.42 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,897.79 / $4,897.79 / $4,897.79
| Professional | | $4,897.79 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $131.83 / $15,135.61
| Professional | | $87.10 | $131.83 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $5,370.32 / $15,488.17
| Facility | | $64.57 | $5,370.32 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $245.47 / $12,589.25
| Professional | | $87.10 | $245.47 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,949.84 / $6,165.95
| Facility | | $512.86 | $1,949.84 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $3,981.07 / $10,964.78
| Facility | | $58.88 | $3,981.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $3,467.37 / $8,317.64
| Professional | | $107.15 | $3,467.37 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $5,128.61 / $7,244.36
| Facility | | $1,513.56 | $5,128.61 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $2,344.23 / $10,715.19
| Professional | | $95.50 | $2,344.23 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $4,365.16 / $18,197.01
| Facility | | $389.05 | $4,365.16 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $1,584.89 / $5,011.87
| Professional | | $83.18 | $1,584.89 | $5,011.87 |