- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.45 / $2,068.29 / $8,498.62
| Facility | | $266.45 | $2,068.29 | $8,498.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.58 / $298.80 / $1,254.26
| Professional | | $204.58 | $298.80 | $1,254.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.00 / $3,496.00 / $5,962.00
| Facility | | $1,905.00 | $3,496.00 | $5,962.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.16 / $612.25 / $1,313.88
| Professional | | $301.16 | $612.25 | $1,313.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $838.94 / $980.37 / $1,503.91
| Facility | | $838.94 | $980.37 | $1,503.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.23 / $455.99 / $861.77
| Professional | | $254.23 | $455.99 | $861.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.16 / $377.46 / $871.05
| Facility | | $243.16 | $377.46 | $871.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.91 / $621.88 / $5,169.00
| Facility | | $265.91 | $621.88 | $5,169.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.35 / $598.12 / $1,835.28
| Professional | | $290.35 | $598.12 | $1,835.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.98 / $259.70 / $660.80
| Professional | | $29.98 | $259.70 | $660.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.16 / $377.46 / $871.05
| Facility | | $243.16 | $377.46 | $871.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.35 / $758.48 / $1,042.85
| Professional | | $550.35 | $758.48 | $1,042.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.12 / $636.33 / $1,163.56
| Facility | | $476.12 | $636.33 | $1,163.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.76 / $1,174.09 / $2,360.71
| Professional | | $305.76 | $1,174.09 | $2,360.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $443.43 / $1,046.58 / $1,356.93
| Professional | | $443.43 | $1,046.58 | $1,356.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,976.00 / $4,155.00 / $5,865.00
| Facility | | $2,976.00 | $4,155.00 | $5,865.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.20 / $487.80 / $1,150.03
| Professional | | $285.20 | $487.80 | $1,150.03 |