- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,698.24 / $5,495.41
| Facility | | $1,096.48 | $1,698.24 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $758.58 / $1,412.54
| Professional | | $501.19 | $758.58 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,365.16 / $8,511.38
| Facility | | $2,041.74 | $4,365.16 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,071.52 / $1,380.38
| Professional | | $851.14 | $1,071.52 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $1,905.46 / $1,905.46
| Facility | | $1,905.46 | $1,905.46 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $831.76 / $1,230.27
| Professional | | $549.54 | $831.76 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,023.29 / $1,819.70
| Facility | | $575.44 | $1,023.29 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $1,148.15 / $1,445.44
| Professional | | $758.58 | $1,148.15 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $7,244.36 / $10,232.93
| Facility | | $5,888.44 | $7,244.36 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $1,000.00 / $1,479.11
| Professional | | $707.95 | $1,000.00 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $891.25 / $3,162.28
| Professional | | $630.96 | $891.25 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $9,332.54 / $18,197.01
| Facility | | $2,344.23 | $9,332.54 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $933.25 / $1,412.54
| Professional | | $602.56 | $933.25 | $1,412.54 |