- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,344.23 / $9,332.54
| Facility | | $446.68 | $2,344.23 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $1,288.25 / $2,818.38
| Professional | | $354.81 | $1,288.25 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $13,803.84 / $21,877.62
| Facility | | $10,000.00 | $13,803.84 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $2,290.87 / $7,762.47
| Professional | | $588.84 | $2,290.87 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $5,623.41 / $8,912.51
| Facility | | $4,786.30 | $5,623.41 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $1,258.93 / $6,456.54
| Professional | | $660.69 | $1,258.93 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,630.27 / $4,786.30
| Facility | | $446.68 | $2,630.27 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $1,230.27 / $5,128.61
| Professional | | $831.76 | $1,230.27 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $8,709.64 / $16,595.87
| Facility | | $407.38 | $8,709.64 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,073.80 / $9,772.37
| Professional | | $2,187.76 | $4,073.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,949.84 / $6,025.60
| Professional | | $724.44 | $1,949.84 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $19,952.62
| Facility | | $13,489.63 | $13,489.63 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $3,715.35 / $12,302.69
| Professional | | $660.69 | $3,715.35 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,454.71 / $8,709.64 / $12,589.25
| Professional | | $2,454.71 | $8,709.64 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $17,378.01
| Facility | | $8,912.51 | $13,803.84 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $1,949.84 / $7,762.47
| Professional | | $457.09 | $1,949.84 | $7,762.47 |