- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,311.31 / $5,128.61
| Facility | | $1,778.28 | $3,311.31 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $676.08 / $1,548.82
| Professional | | $549.54 | $676.08 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $6,165.95 / $45,708.82
| Facility | | $1,479.11 | $6,165.95 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $933.25 / $4,466.84
| Professional | | $524.81 | $933.25 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $933.25 / $1,737.80
| Professional | | $524.81 | $933.25 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,288.25 / $7,079.46
| Facility | | $575.44 | $1,288.25 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $831.76 / $1,148.15
| Professional | | $660.69 | $831.76 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $1,122.02 / $1,778.28
| Professional | | $602.56 | $1,122.02 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $6,165.95 / $45,708.82
| Facility | | $1,479.11 | $6,165.95 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $933.25 / $4,466.84
| Professional | | $524.81 | $933.25 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $13,182.57
| Facility | | $2,041.74 | $5,248.07 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $912.01 / $1,862.09
| Professional | | $588.84 | $912.01 | $1,862.09 |