- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.24 / $1,198.32 / $18,711.00
| Facility | | $584.24 | $1,198.32 | $18,711.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.80 / $584.24 / $1,198.32
| Professional | | $333.80 | $584.24 | $1,198.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,335.32 / $9,124.02 / $20,178.18
| Facility | | $2,335.32 | $9,124.02 | $20,178.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.57 / $895.82 / $3,354.72
| Professional | | $550.57 | $895.82 | $3,354.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $3,302.92
| Facility | | $714.97 | $870.49 | $3,302.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $378.02 / $709.48 / $1,294.24
| Professional | | $378.02 | $709.48 | $1,294.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.60 / $709.63 / $2,478.65
| Facility | | $385.60 | $709.63 | $2,478.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.23 / $696.24 / $1,495.98
| Professional | | $383.23 | $696.24 | $1,495.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.44 / $391.74 / $1,016.26
| Professional | | $37.44 | $391.74 | $1,016.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.32 / $824.77 / $910.53
| Facility | | $546.32 | $824.77 | $910.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.58 / $621.05 / $2,412.73
| Facility | | $601.58 | $621.05 | $2,412.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $550.40 / $805.98 / $1,127.73
| Professional | | $550.40 | $805.98 | $1,127.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,812.14 / $9,118.81 / $17,453.22
| Facility | | $6,812.14 | $9,118.81 | $17,453.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $521.51 / $740.28 / $1,074.83
| Professional | | $521.51 | $740.28 | $1,074.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $4,016.00 / $16,315.00
| Facility | | $2,912.00 | $4,016.00 | $16,315.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $527.17 / $711.08 / $1,285.33
| Professional | | $527.17 | $711.08 | $1,285.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.28 / $373.52 / $500.97
| Professional | | $361.28 | $373.52 | $500.97 |