- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $1,949.84 / $7,244.36
| Facility | | $436.52 | $1,949.84 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $478.63 / $1,737.80
| Professional | | $257.04 | $478.63 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $229.09 / $436.52
| Professional | | $208.93 | $229.09 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $478.63 / $758.58
| Professional | | $295.12 | $478.63 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $707.95 / $776.25
| Professional | | $549.54 | $707.95 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $616.60 / $891.25
| Professional | | $416.87 | $616.60 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,288.25 / $2,754.23
| Facility | | $851.14 | $1,288.25 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $457.09 / $524.81
| Professional | | $331.13 | $457.09 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $1,698.24 / $7,244.36
| Facility | | $446.68 | $1,698.24 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $489.78 / $1,174.90
| Professional | | $269.15 | $489.78 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $489.78
| Professional | | $489.78 | $489.78 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $457.09 / $524.81
| Facility | | $295.12 | $457.09 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $457.09 / $524.81
| Professional | | $295.12 | $457.09 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $1,047.13 / $3,890.45
| Facility | | $223.87 | $1,047.13 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $457.09 / $758.58
| Professional | | $275.42 | $457.09 | $758.58 |