- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $954.99 / $21,877.62
| Facility | | $288.40 | $954.99 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $426.58 / $912.01
| Professional | | $288.40 | $426.58 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $891.25 / $1,949.84
| Professional | | $446.68 | $891.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,445.44 / $2,344.23
| Facility | | $1,230.27 | $1,445.44 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $776.25 / $1,258.93
| Professional | | $398.11 | $776.25 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $891.25 / $4,897.79
| Facility | | $338.84 | $891.25 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $933.25 / $1,380.38
| Professional | | $630.96 | $933.25 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $891.25 / $5,128.61
| Facility | | $363.08 | $891.25 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $794.33 / $3,019.95
| Professional | | $436.52 | $794.33 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $1,023.29
| Professional | | $32.36 | $33.11 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $1,000.00 / $1,548.82
| Professional | | $602.56 | $1,000.00 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,623.41 / $5,623.41
| Facility | | $3,801.89 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $616.60 / $3,388.44
| Professional | | $346.74 | $616.60 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $1,479.11 / $1,995.26
| Professional | | $758.58 | $1,479.11 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,606.93
| Facility | | $2,884.03 | $3,801.89 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $616.60 / $1,548.82
| Professional | | $354.81 | $616.60 | $1,548.82 |