- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $5,011.87 / $9,332.54
| Facility | | $2,691.53 | $5,011.87 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $691.83 / $2,290.87
| Professional | | $467.74 | $691.83 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $11,748.98 / $43,651.58
| Facility | | $1,230.27 | $11,748.98 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $794.33 / $7,244.36
| Professional | | $407.38 | $794.33 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $1,071.52 / $1,905.46
| Professional | | $660.69 | $1,071.52 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $954.99 / $7,079.46
| Facility | | $457.09 | $954.99 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $645.65 / $1,202.26
| Professional | | $537.03 | $645.65 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $7,762.47 / $48,977.88
| Facility | | $2,754.23 | $7,762.47 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $831.76 / $1,659.59
| Professional | | $467.74 | $831.76 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $19,952.62 / $34,673.69
| Facility | | $4,265.80 | $19,952.62 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $14,125.38 / $43,651.58
| Facility | | $1,230.27 | $14,125.38 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $794.33 / $7,244.36
| Professional | | $407.38 | $794.33 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $7,943.28 / $44,668.36
| Facility | | $2,754.23 | $7,943.28 | $44,668.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $870.96 / $2,041.74
| Professional | | $575.44 | $870.96 | $2,041.74 |