- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.19 / $9,513.92 / $27,982.24
| Facility | | $440.19 | $9,513.92 | $27,982.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.19 / $440.19 / $679.68
| Professional | | $276.19 | $440.19 | $679.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.32 / $721.34 / $2,002.76
| Facility | | $599.32 | $721.34 | $2,002.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $611.23 / $1,041.33 / $3,857.70
| Professional | | $611.23 | $1,041.33 | $3,857.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,132.00 / $17,691.00 / $36,898.00
| Facility | | $17,132.00 | $17,691.00 | $36,898.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,352.59 / $1,352.59 / $1,352.59
| Professional | | $1,352.59 | $1,352.59 | $1,352.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.00 / $50.00 / $50.00
| Professional | | $45.00 | $50.00 | $50.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.26 / $438.99 / $477.97
| Facility | | $363.26 | $438.99 | $477.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.32 / $599.32 / $604.15
| Facility | | $599.32 | $599.32 | $604.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.87 / $1,005.91 / $1,203.95
| Professional | | $621.87 | $1,005.91 | $1,203.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $611.23 / $869.08 / $1,170.63
| Professional | | $611.23 | $869.08 | $1,170.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $3,323.00 / $36,803.00
| Facility | | $1,120.00 | $3,323.00 | $36,803.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $552.20 / $752.99 / $1,304.34
| Professional | | $552.20 | $752.99 | $1,304.34 |