- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $10,471.29 / $22,908.68
| Facility | | $3,715.35 | $10,471.29 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $194.98 / $812.83
| Professional | | $151.36 | $194.98 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $11,220.18 / $17,782.79
| Facility | | $6,456.54 | $11,220.18 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $275.42 / $562.34
| Professional | | $199.53 | $275.42 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $100.00 / $1,862.09
| Facility | | $60.26 | $100.00 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $194.98 / $457.09
| Professional | | $134.90 | $194.98 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $199.53 / $446.68
| Professional | | $162.18 | $199.53 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $144.54 / $186.21
| Professional | | $134.90 | $144.54 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $162.18 / $316.23
| Professional | | $123.03 | $162.18 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $977.24
| Facility | | $54.95 | $56.23 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,348.96 / $1,348.96
| Professional | | $1,122.02 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $190.55 / $275.42
| Facility | | $141.25 | $190.55 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $199.53 / $436.52
| Professional | | $162.18 | $199.53 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $158.49 / $229.09
| Professional | | $117.49 | $158.49 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $6,165.95 / $18,620.87
| Facility | | $2,041.74 | $6,165.95 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $204.17 / $426.58
| Professional | | $138.04 | $204.17 | $426.58 |