- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $3,715.35 / $8,317.64
| Facility | | $389.05 | $3,715.35 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $288.40 / $831.76
| Professional | | $194.98 | $288.40 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $537.03 / $537.03
| Professional | | $467.74 | $537.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $309.03 / $501.19
| Professional | | $204.17 | $309.03 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $489.78 / $537.03
| Professional | | $380.19 | $489.78 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $371.54 / $562.34
| Professional | | $257.04 | $371.54 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $3,981.07 / $8,128.31
| Facility | | $3,311.31 | $3,981.07 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $302.00 / $346.74
| Professional | | $288.40 | $302.00 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $2,818.38 / $7,762.47
| Facility | | $524.81 | $2,818.38 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $309.03 / $707.95
| Professional | | $199.53 | $309.03 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Professional | | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $309.03 / $416.87
| Facility | | $218.78 | $309.03 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $309.03 / $416.87
| Professional | | $218.78 | $309.03 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,187.76 / $5,248.07
| Facility | | $467.74 | $2,187.76 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $295.12 / $501.19
| Professional | | $194.98 | $295.12 | $501.19 |