- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,548.82 / $3,090.30
| Facility | | $309.03 | $1,548.82 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $1,023.29 / $2,290.87
| Professional | | $269.15 | $1,023.29 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $1,412.54 / $5,248.07
| Professional | | $371.54 | $1,412.54 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $3,981.07 / $6,309.57
| Facility | | $3,388.44 | $3,981.07 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $1,230.27 / $4,570.88
| Professional | | $338.84 | $1,230.27 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $1,479.11 / $3,388.44
| Facility | | $281.84 | $1,479.11 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $912.01 / $3,630.78
| Professional | | $467.74 | $912.01 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,659.59 / $10,232.93
| Facility | | $295.12 | $1,659.59 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,621.81 / $3,090.30 / $9,332.54
| Professional | | $1,621.81 | $3,090.30 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $363.08
| Professional | | $32.36 | $33.11 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $1,348.96 / $4,168.69
| Professional | | $436.52 | $1,348.96 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $11,481.54 / $11,481.54
| Facility | | $616.60 | $11,481.54 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $2,570.40 / $8,709.64
| Professional | | $416.87 | $2,570.40 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $5,754.40 / $8,912.51
| Professional | | $1,318.26 | $5,754.40 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $12,589.25
| Facility | | $6,606.93 | $10,232.93 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $1,445.44 / $4,897.79
| Professional | | $323.59 | $1,445.44 | $4,897.79 |