- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $1,949.84 / $14,454.40
| Facility | | $57.54 | $1,949.84 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $1,000.00 / $2,884.03
| Professional | | $67.61 | $1,000.00 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $741.31 / $9,772.37
| Professional | | $151.36 | $741.31 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $10,000.00 / $15,848.93
| Facility | | $8,511.38 | $10,000.00 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $2,290.87 / $9,332.54
| Professional | | $128.82 | $2,290.87 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $288.40 / $15,135.61
| Facility | | $87.10 | $288.40 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $281.84 / $7,943.28
| Professional | | $173.78 | $281.84 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $1,445.44 / $12,022.64
| Facility | | $95.50 | $1,445.44 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,621.81 / $3,162.28 / $8,317.64
| Professional | | $1,621.81 | $3,162.28 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $3,981.07 / $19,952.62
| Professional | | $158.49 | $3,981.07 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $17,782.79
| Facility | | $6,760.83 | $6,760.83 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,897.79 / $23,442.29 / $40,738.03
| Professional | | $4,897.79 | $23,442.29 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $3,235.94
| Professional | | $181.97 | $181.97 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $537.03 / $13,489.63
| Professional | | $407.38 | $537.03 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,584.89 / $2,187.76
| Facility | | $1,023.29 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $1,380.38 / $6,918.31
| Professional | | $104.71 | $1,380.38 | $6,918.31 |