- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,890.45 / $14,454.40
| Facility | | $1,096.48 | $3,890.45 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $446.68 / $676.08
| Professional | | $371.54 | $446.68 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,786.30 / $9,120.11
| Facility | | $2,691.53 | $4,786.30 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $436.52 / $588.84
| Professional | | $338.84 | $436.52 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Facility | | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Facility | | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $512.86 / $851.14
| Professional | | $389.05 | $512.86 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $10,964.78
| Facility | | $54.95 | $56.23 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,235.94 / $3,235.94 / $3,235.94
| Professional | | $3,235.94 | $3,235.94 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $1,071.52 / $8,709.64
| Facility | | $416.87 | $1,071.52 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $478.63 / $1,000.00
| Professional | | $371.54 | $478.63 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $295.12
| Professional | | $32.36 | $33.11 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $524.81 / $912.01
| Facility | | $380.19 | $524.81 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $512.86 / $812.83
| Professional | | $371.54 | $512.86 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $10,964.78
| Facility | | $1,698.24 | $5,248.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $426.58 / $660.69
| Professional | | $316.23 | $426.58 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $363.08
| Professional | | $331.13 | $331.13 | $363.08 |