- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $389.05 / $14,454.40
| Facility | | $245.47 | $389.05 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $245.47 / $457.09
| Professional | | $181.97 | $245.47 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $17,378.01
| Facility | | $6,606.93 | $10,964.78 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $371.54 / $1,096.48
| Professional | | $194.98 | $371.54 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $575.44 / $912.01
| Facility | | $489.78 | $575.44 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $602.56 / $691.83
| Professional | | $331.13 | $602.56 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $7,413.10 / $14,454.40
| Facility | | $223.87 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $501.19 / $588.84
| Professional | | $407.38 | $501.19 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $3,388.44 / $9,549.93
| Facility | | $223.87 | $3,388.44 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $407.38 / $1,096.48
| Professional | | $239.88 | $407.38 | $1,096.48 |
- 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
- $309.03 / $489.78 / $691.83
| Professional | | $309.03 | $489.78 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $1,258.93
| Facility | | $489.78 | $489.78 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $977.24 / $1,412.54
| Professional | | $331.13 | $977.24 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,000.00
| Professional | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,318.26 / $1,348.96
| Professional | | $870.96 | $1,318.26 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $398.11 / $891.25
| Professional | | $234.42 | $398.11 | $891.25 |