- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,311.31 / $4,897.79
| Facility | | $1,023.29 | $3,311.31 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $724.44 / $3,467.37
| Professional | | $158.49 | $724.44 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,344.23 / $4,677.35
| Facility | | $56.23 | $2,344.23 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $616.60 / $2,187.76
| Professional | | $186.21 | $616.60 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $467.74
| Facility | | $199.53 | $199.53 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $1,819.70
| Professional | | $398.11 | $398.11 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $891.25 / $2,570.40
| Professional | | $257.04 | $891.25 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $501.19 / $7,079.46
| Facility | | $154.88 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,096.48 / $2,041.74
| Professional | | $851.14 | $1,096.48 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $741.31 / $1,862.09
| Professional | | $181.97 | $741.31 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,148.15
| Facility | | $1,000.00 | $1,000.00 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,621.81 / $1,621.81
| Professional | | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $2,344.23 / $4,677.35
| Facility | | $56.23 | $2,344.23 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $616.60 / $2,187.76
| Professional | | $186.21 | $616.60 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $794.33 / $1,949.84
| Professional | | $223.87 | $794.33 | $1,949.84 |