- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,495.41 / $36,307.81
| Facility | | $2,137.96 | $5,495.41 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $691.83 / $2,691.53
| Professional | | $512.86 | $691.83 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $446.68
| Professional | | $416.87 | $416.87 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $14,125.38 / $17,378.01
| Facility | | $10,715.19 | $14,125.38 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $741.31 / $1,023.29
| Professional | | $537.03 | $741.31 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $8,128.31 / $15,848.93
| Facility | | $8,128.31 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $724.44 / $1,047.13
| Professional | | $457.09 | $724.44 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $741.31 / $12,022.64
| Professional | | $467.74 | $741.31 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $8,128.31 / $8,128.31
| Facility | | $8,128.31 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $12,022.64
| Professional | | $660.69 | $660.69 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Professional | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $20,892.96 / $34,673.69
| Facility | | $4,897.79 | $20,892.96 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $630.96 / $933.25
| Professional | | $501.19 | $630.96 | $933.25 |