- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $3,019.95 / $12,022.64
| Facility | | $204.17 | $3,019.95 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $2,344.23 / $5,623.41
| Professional | | $204.17 | $2,344.23 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $588.84 / $3,890.45
| Professional | | $309.03 | $588.84 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $9,332.54 / $14,791.08
| Facility | | $7,943.28 | $9,332.54 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $1,380.38 / $14,125.38
| Professional | | $338.84 | $1,380.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $3,715.35 / $9,332.54
| Facility | | $223.87 | $3,715.35 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $741.31 / $7,585.78
| Professional | | $380.19 | $741.31 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,445.44 / $5,754.40
| Facility | | $229.09 | $1,445.44 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,365.16 / $7,762.47 / $31,622.78
| Professional | | $4,365.16 | $7,762.47 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $3,311.31 / $9,772.37
| Professional | | $371.54 | $3,311.31 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $537.03 / $18,197.01
| Facility | | $537.03 | $537.03 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $7,762.47 / $31,622.78
| Professional | | $380.19 | $7,762.47 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $12,022.64 / $18,620.87
| Professional | | $912.01 | $12,022.64 | $18,620.87 |
- 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
- $251.19 / $2,818.38 / $13,182.57
| Professional | | $251.19 | $2,818.38 | $13,182.57 |