- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $891.25 / $14,454.40
| Facility | | $537.03 | $891.25 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $537.03 / $891.25
| Professional | | $398.11 | $537.03 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $18,197.01 / $28,840.32
| Facility | | $12,882.50 | $18,197.01 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $831.76 / $2,398.83
| Professional | | $426.58 | $831.76 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,288.25 / $2,089.30
| Facility | | $1,122.02 | $1,288.25 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $1,348.96 / $1,548.82
| Professional | | $741.31 | $1,348.96 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $7,413.10 / $14,454.40
| Facility | | $501.19 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $912.01 / $1,148.15 / $1,318.26
| Professional | | $912.01 | $1,148.15 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $16,595.87 / $75,857.76
| Facility | | $489.78 | $16,595.87 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $954.99 / $2,398.83
| Professional | | $549.54 | $954.99 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $85.11
| Professional | | $32.36 | $33.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,047.13 / $1,862.09
| Professional | | $724.44 | $1,047.13 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $28,840.32 / $42,657.95
| Facility | | $28,840.32 | $28,840.32 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $2,137.96 / $3,162.28
| Professional | | $741.31 | $2,137.96 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,238.72 / $2,238.72
| Professional | | $2,238.72 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,511.89 / $3,019.95 / $3,388.44
| Professional | | $2,511.89 | $3,019.95 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $20,417.38 / $83,176.38
| Facility | | $8,709.64 | $20,417.38 | $83,176.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $933.25 / $1,949.84
| Professional | | $512.86 | $933.25 | $1,949.84 |