- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $3,090.30 / $7,762.47
| Facility | | $457.09 | $3,090.30 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $446.68 / $1,096.48
| Professional | | $275.42 | $446.68 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $229.09
| Professional | | $229.09 | $229.09 | $229.09 |
- 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
- $891.25 / $891.25 / $954.99
| Professional | | $891.25 | $891.25 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $501.19 / $812.83
| Professional | | $331.13 | $501.19 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $758.58 / $831.76
| Professional | | $588.84 | $758.58 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $645.65 / $933.25
| Professional | | $436.52 | $645.65 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,584.89 / $2,754.23
| Facility | | $616.60 | $1,584.89 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $489.78 / $524.81
| Professional | | $331.13 | $489.78 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,630.27 / $7,244.36
| Facility | | $537.03 | $2,630.27 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $501.19 / $1,122.02
| Professional | | $302.00 | $501.19 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $562.34 / $562.34
| Professional | | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $467.74 / $575.44
| Facility | | $323.59 | $467.74 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $467.74 / $512.86
| Professional | | $323.59 | $467.74 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $1,230.27 / $3,890.45
| Facility | | $223.87 | $1,230.27 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $478.63 / $794.33
| Professional | | $309.03 | $478.63 | $794.33 |