- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,677.35 / $8,709.64
| Facility | | $2,691.53 | $4,677.35 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $478.63 / $1,479.11
| Professional | | $251.19 | $478.63 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $18,197.01 / $102,329.30
| Facility | | $870.96 | $18,197.01 | $102,329.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $630.96 / $19,498.45
| Professional | | $281.84 | $630.96 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $758.58 / $1,348.96
| Professional | | $467.74 | $758.58 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $676.08 / $7,079.46
| Facility | | $316.23 | $676.08 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $457.09 / $870.96
| Professional | | $371.54 | $457.09 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $9,549.93 / $89,125.09
| Facility | | $2,818.38 | $9,549.93 | $89,125.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $588.84 / $1,148.15
| Professional | | $331.13 | $588.84 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $43,651.58 / $102,329.30
| Facility | | $870.96 | $43,651.58 | $102,329.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $630.96 / $19,498.45
| Professional | | $281.84 | $630.96 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $9,549.93 / $81,283.05
| Facility | | $2,691.53 | $9,549.93 | $81,283.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $707.95 / $1,513.56
| Professional | | $426.58 | $707.95 | $1,513.56 |