- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $1,949.84 / $3,090.30
| Facility | | $257.04 | $1,949.84 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $436.52 / $1,548.82
| Professional | | $263.03 | $436.52 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,897.79 / $7,585.78
| Facility | | $3,311.31 | $4,897.79 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $851.14 / $1,737.80
| Professional | | $457.09 | $851.14 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,445.44 / $2,290.87
| Facility | | $1,230.27 | $1,445.44 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $912.01 / $1,380.38
| Professional | | $512.86 | $912.01 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $707.95 / $4,168.69
| Facility | | $269.15 | $707.95 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $912.01 / $1,348.96
| Professional | | $660.69 | $912.01 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $912.01 / $8,317.64
| Facility | | $275.42 | $912.01 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $851.14 / $3,467.37
| Professional | | $467.74 | $851.14 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $616.60
| Professional | | $32.36 | $33.11 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $1,023.29 / $1,698.24
| Professional | | $575.44 | $1,023.29 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,981.07 / $3,981.07
| Facility | | $2,754.23 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $1,096.48 / $3,311.31
| Professional | | $371.54 | $1,096.48 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $1,318.26 / $1,995.26
| Professional | | $549.54 | $1,318.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $7,413.10 / $9,120.11
| Facility | | $4,786.30 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $660.69 / $1,584.89
| Professional | | $323.59 | $660.69 | $1,584.89 |