- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.41 / $3,326.18 / $10,034.00
| Facility | | $360.41 | $3,326.18 | $10,034.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.74 / $406.30 / $765.50
| Professional | | $271.74 | $406.30 | $765.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,704.83 / $1,704.83 / $1,729.70
| Facility | | $1,704.83 | $1,704.83 | $1,729.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $368.31 / $595.60 / $1,055.83
| Professional | | $368.31 | $595.60 | $1,055.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $2,710.28
| Facility | | $748.70 | $748.70 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.77 / $522.09 / $1,067.26
| Professional | | $352.77 | $522.09 | $1,067.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.89 / $514.22 / $760.94
| Facility | | $279.89 | $514.22 | $760.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.00 / $699.00 / $749.00
| Professional | | $538.00 | $699.00 | $749.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $549.20 / $1,321.80
| Professional | | $3.00 | $549.20 | $1,321.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.24 / $519.04 / $1,083.07
| Professional | | $367.24 | $519.04 | $1,083.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,303.04 / $1,434.98 / $26,542.00
| Facility | | $1,303.04 | $1,434.98 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,084.40 / $3,036.32 / $3,475.35
| Professional | | $2,084.40 | $3,036.32 | $3,475.35 |