- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $426.58 / $3,162.28
| Facility | | $295.12 | $426.58 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $371.54 / $1,023.29
| Professional | | $245.47 | $371.54 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,570.88 / $7,079.46
| Facility | | $2,344.23 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $512.86 / $1,258.93
| Professional | | $331.13 | $512.86 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,174.90 / $1,862.09
| Facility | | $1,000.00 | $1,174.90 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $954.99 / $1,737.80
| Professional | | $389.05 | $954.99 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $512.86 / $3,548.13
| Facility | | $269.15 | $512.86 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $707.95 / $1,023.29
| Professional | | $489.78 | $707.95 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $537.03 / $3,981.07
| Facility | | $275.42 | $537.03 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $676.08 / $2,754.23
| Professional | | $354.81 | $676.08 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $346.74
| Professional | | $32.36 | $33.11 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $831.76 / $1,318.26
| Professional | | $489.78 | $831.76 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $977.24 / $1,819.70
| Facility | | $512.86 | $977.24 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $1,412.54 / $2,691.53
| Professional | | $426.58 | $1,412.54 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,659.59 / $2,398.83
| Professional | | $630.96 | $1,659.59 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,884.03 / $5,011.87
| Facility | | $2,344.23 | $2,884.03 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $489.78 / $1,258.93
| Professional | | $288.40 | $489.78 | $1,258.93 |