- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,090.30 / $5,370.32
| Facility | | $562.34 | $3,090.30 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $131.83 / $316.23
| Professional | | $83.18 | $131.83 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $5,011.87 / $33,884.42
| Facility | | $295.12 | $5,011.87 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $181.97 / $870.96
| Professional | | $102.33 | $181.97 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $245.47 / $323.59
| Professional | | $144.54 | $245.47 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $245.47 / $457.09
| Professional | | $147.91 | $245.47 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $575.44 / $7,079.46
| Facility | | $114.82 | $575.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $162.18 / $269.15
| Professional | | $128.82 | $162.18 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $208.93 / $338.84
| Professional | | $117.49 | $208.93 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,466.84 / $5,128.61
| Facility | | $1,862.09 | $4,466.84 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $104.71 / $104.71
| Professional | | $104.71 | $104.71 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $5,011.87 / $33,884.42
| Facility | | $295.12 | $5,011.87 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $173.78 / $870.96
| Professional | | $102.33 | $173.78 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $199.53 / $398.11
| Professional | | $131.83 | $199.53 | $398.11 |