- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $2,754.23 / $7,079.46
| Facility | | $269.15 | $2,754.23 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $245.47 / $501.19
| Professional | | $158.49 | $245.47 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $281.84 / $436.52
| Professional | | $181.97 | $281.84 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $3,235.94 / $4,466.84
| Professional | | $186.21 | $3,235.94 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $1,659.59
| Facility | | $302.00 | $302.00 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $263.03 / $436.52
| Professional | | $186.21 | $263.03 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $346.74 / $407.38
| Professional | | $263.03 | $346.74 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $346.74
| Professional | | $302.00 | $302.00 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $245.47 / $389.05
| Facility | | $169.82 | $245.47 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $1,174.90
| Professional | | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $234.42 / $8,709.64
| Facility | | $162.18 | $234.42 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $331.13 / $8,709.64
| Professional | | $199.53 | $331.13 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,244.36 / $14,125.38
| Facility | | $3,890.45 | $7,244.36 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $234.42 / $407.38
| Professional | | $154.88 | $234.42 | $407.38 |