- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $3,162.28 / $4,786.30
| Facility | | $181.97 | $3,162.28 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $512.86 / $2,398.83
| Professional | | $75.86 | $512.86 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,584.89 / $1,584.89
| Facility | | $1,202.26 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $758.58 / $2,344.23
| Professional | | $144.54 | $758.58 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,862.09 / $3,019.95
| Facility | | $1,621.81 | $1,862.09 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $446.68 / $1,778.28
| Professional | | $147.91 | $446.68 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $1,445.44 / $4,265.80
| Facility | | $97.72 | $1,445.44 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $302.00 / $1,698.24
| Professional | | $190.55 | $302.00 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $1,122.02 / $1,778.28
| Facility | | $89.13 | $1,122.02 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $1,445.44 / $3,090.30
| Professional | | $758.58 | $1,445.44 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $269.15
| Professional | | $32.36 | $33.11 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $616.60 / $1,905.46
| Professional | | $147.91 | $616.60 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $1,778.28
| Facility | | $229.09 | $229.09 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $1,174.90 / $4,073.80
| Professional | | $165.96 | $1,174.90 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $1,258.93 / $2,511.89
| Professional | | $190.55 | $1,258.93 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,584.89 / $1,949.84
| Facility | | $1,023.29 | $1,584.89 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $524.81 / $2,630.27
| Professional | | $107.15 | $524.81 | $2,630.27 |