- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $776.25 / $3,467.37
| Facility | | $239.88 | $776.25 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $371.54 / $1,000.00
| Professional | | $229.09 | $371.54 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $537.03 / $1,202.26
| Professional | | $346.74 | $537.03 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,202.26 / $1,905.46
| Facility | | $1,023.29 | $1,202.26 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $954.99 / $1,778.28
| Professional | | $398.11 | $954.99 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $478.63 / $3,162.28
| Facility | | $239.88 | $478.63 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $676.08 / $1,047.13
| Professional | | $457.09 | $676.08 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $512.86 / $7,244.36
| Facility | | $239.88 | $512.86 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $776.25 / $2,818.38
| Professional | | $380.19 | $776.25 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $331.13
| Professional | | $32.36 | $33.11 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $758.58 / $1,230.27
| Professional | | $446.68 | $758.58 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,258.93 / $2,290.87
| Facility | | $489.78 | $1,258.93 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $1,905.46 / $2,691.53
| Professional | | $457.09 | $1,905.46 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $1,584.89 / $2,454.71
| Professional | | $269.15 | $1,584.89 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $7,413.10 / $9,120.11
| Facility | | $4,786.30 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $501.19 / $1,380.38
| Professional | | $281.84 | $501.19 | $1,380.38 |