- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.75 / $7,146.30 / $18,293.00
| Facility | | $522.75 | $7,146.30 | $18,293.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.42 / $460.22 / $2,210.98
| Professional | | $331.42 | $460.22 | $2,210.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,894.00 / $4,734.00 / $9,589.00
| Facility | | $1,894.00 | $4,734.00 | $9,589.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.76 / $510.28 / $1,147.29
| Professional | | $342.76 | $510.28 | $1,147.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $5,487.90
| Facility | | $66.00 | $100.00 | $5,487.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.15 / $547.35 / $1,156.02
| Professional | | $383.15 | $547.35 | $1,156.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.30 / $609.25 / $1,219.34
| Professional | | $399.30 | $609.25 | $1,219.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.65 / $521.77 / $731.72
| Professional | | $168.65 | $521.77 | $731.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.27 / $551.45 / $938.26
| Professional | | $383.27 | $551.45 | $938.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,747.40 / $1,922.99
| Facility | | $55.00 | $1,747.40 | $1,922.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,719.44 / $3,530.64 / $4,092.30
| Professional | | $2,719.44 | $3,530.64 | $4,092.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.65 / $490.14 / $768.96
| Facility | | $337.65 | $490.14 | $768.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.84 / $632.89 / $1,219.34
| Professional | | $404.84 | $632.89 | $1,219.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,306.81 / $1,306.81 / $1,799.69
| Professional | | $1,306.81 | $1,306.81 | $1,799.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $219.25 / $366.66 / $677.75
| Professional | | $219.25 | $366.66 | $677.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,410.00 / $2,761.00 / $7,655.00
| Facility | | $1,410.00 | $2,761.00 | $7,655.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $415.49 / $553.98 / $1,239.70
| Professional | | $415.49 | $553.98 | $1,239.70 |