- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.39 / $2,663.12 / $4,806.64
| Facility | | $453.39 | $2,663.12 | $4,806.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.76 / $432.37 / $730.32
| Professional | | $269.76 | $432.37 | $730.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.14 / $2,854.00 / $9,039.00
| Facility | | $695.14 | $2,854.00 | $9,039.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.25 / $752.39 / $3,341.28
| Professional | | $353.25 | $752.39 | $3,341.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.66 / $457.02 / $815.88
| Facility | | $355.66 | $457.02 | $815.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.97 / $715.56 / $1,220.08
| Professional | | $487.97 | $715.56 | $1,220.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.92 / $627.83 / $1,186.99
| Professional | | $377.92 | $627.83 | $1,186.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.20 / $648.50 / $6,679.00
| Facility | | $300.20 | $648.50 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $534.71 / $651.86 / $899.82
| Professional | | $534.71 | $651.86 | $899.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $388.79 / $817.50 / $1,326.99
| Professional | | $388.79 | $817.50 | $1,326.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,361.69 / $4,232.85 / $25,429.46
| Facility | | $1,361.69 | $4,232.85 | $25,429.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,523.47 / $3,764.00 / $26,542.00
| Facility | | $1,523.47 | $3,764.00 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.22 / $970.19 / $3,341.28
| Professional | | $496.22 | $970.19 | $3,341.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.16 / $735.72 / $1,398.25
| Professional | | $482.16 | $735.72 | $1,398.25 |