- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $288.40 / $6,456.54
| Facility | | $117.49 | $288.40 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $229.09 / $436.52
| Professional | | $117.49 | $229.09 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,317.64 / $13,182.57
| Facility | | $5,011.87 | $8,317.64 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $446.68 / $977.24
| Professional | | $223.87 | $446.68 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $851.14 / $1,348.96
| Facility | | $724.44 | $851.14 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $416.87 / $812.83
| Professional | | $245.47 | $416.87 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $416.87 / $6,918.31
| Facility | | $151.36 | $416.87 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $467.74 / $794.33
| Professional | | $302.00 | $467.74 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $549.54 / $11,481.54
| Facility | | $151.36 | $549.54 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $524.81 / $2,041.74
| Professional | | $245.47 | $524.81 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $371.54
| Professional | | $32.36 | $33.11 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $446.68 / $954.99
| Professional | | $245.47 | $446.68 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $8,709.64 / $8,709.64
| Facility | | $5,888.44 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $660.69 / $2,137.96
| Professional | | $213.80 | $660.69 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $524.81
| Professional | | $257.04 | $257.04 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $588.84 / $1,148.15
| Professional | | $295.12 | $588.84 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $13,182.57
| Facility | | $6,606.93 | $10,232.93 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $354.81 / $977.24
| Professional | | $154.88 | $354.81 | $977.24 |