- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $4,265.80 / $8,317.64
| Facility | | $1,047.13 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $1,174.90 / $2,290.87
| Professional | | $331.13 | $1,174.90 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,737.80 / $2,454.71
| Professional | | $1,174.90 | $1,737.80 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $707.95 / $2,344.23
| Professional | | $323.59 | $707.95 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,630.27 / $2,754.23
| Professional | | $2,630.27 | $2,630.27 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $1,949.84 / $2,754.23
| Professional | | $446.68 | $1,949.84 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,801.89 / $8,317.64
| Facility | | $954.99 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $1,288.25 / $3,467.37
| Professional | | $354.81 | $1,288.25 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $2,511.89 / $4,168.69
| Professional | | $3.98 | $2,511.89 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,096.48 / $1,698.24
| Facility | | $323.59 | $1,096.48 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $575.44 / $1,513.56
| Professional | | $194.98 | $575.44 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,981.07 / $9,772.37
| Facility | | $2,089.30 | $3,981.07 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $1,122.02 / $2,290.87
| Professional | | $338.84 | $1,122.02 | $2,290.87 |