- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,174.90 / $14,454.40
| Facility | | $549.54 | $1,174.90 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $575.44 / $1,479.11
| Professional | | $512.86 | $575.44 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,897.79 / $7,585.78
| Facility | | $3,311.31 | $4,897.79 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $1,148.15 / $2,754.23
| Professional | | $549.54 | $1,148.15 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,737.80 / $2,754.23
| Facility | | $1,479.11 | $1,737.80 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $2,290.87 / $2,630.27
| Professional | | $691.83 | $2,290.87 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,148.15 / $4,168.69
| Facility | | $562.34 | $1,148.15 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,348.96 / $1,659.59
| Professional | | $1,023.29 | $1,348.96 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,230.27 / $5,623.41
| Facility | | $562.34 | $1,230.27 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $870.96 / $4,466.84
| Professional | | $537.03 | $870.96 | $4,466.84 |
- 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
- $851.14 / $1,288.25 / $1,949.84
| Professional | | $851.14 | $1,288.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $5,248.07
| Facility | | $3,548.13 | $3,548.13 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,691.53 / $4,466.84
| Professional | | $1,000.00 | $2,691.53 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Professional | | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,090.30 / $3,630.78
| Professional | | $1,445.44 | $3,090.30 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,606.93
| Facility | | $2,884.03 | $3,801.89 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $794.33 / $2,290.87
| Professional | | $537.03 | $794.33 | $2,290.87 |