- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.31 / $8,042.03 / $19,276.96
| Facility | | $388.31 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.54 / $388.31 / $1,479.21
| Professional | | $260.54 | $388.31 | $1,479.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.62 / $1,186.41 / $1,186.41
| Professional | | $243.62 | $1,186.41 | $1,186.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,712.35 / $6,198.03 / $11,988.99
| Facility | | $4,712.35 | $6,198.03 | $11,988.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $278.62 / $523.25 / $795.04
| Professional | | $278.62 | $523.25 | $795.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $502.90 / $815.86 / $1,207.60
| Professional | | $502.90 | $815.86 | $1,207.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.01 / $509.39 / $1,328.48
| Facility | | $310.01 | $509.39 | $1,328.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.47 / $887.89 / $2,118.64
| Professional | | $523.47 | $887.89 | $2,118.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.26 / $909.74 / $2,842.49
| Facility | | $622.26 | $909.74 | $2,842.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $572.96 / $788.00 / $1,116.93
| Professional | | $572.96 | $788.00 | $1,116.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.47 / $895.50 / $1,127.48
| Professional | | $523.47 | $895.50 | $1,127.48 |