- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $5,248.07 / $15,135.61
| Facility | | $524.81 | $5,248.07 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $1,698.24 / $3,162.28
| Professional | | $457.09 | $1,698.24 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $12,302.69 / $17,782.79
| Facility | | $9,772.37 | $12,302.69 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $1,318.26 / $2,630.27
| Professional | | $446.68 | $1,318.26 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $5,011.87 / $6,918.31
| Professional | | $446.68 | $5,011.87 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $1,202.26 / $3,715.35
| Professional | | $478.63 | $1,202.26 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $1,905.46 / $2,344.23
| Professional | | $363.08 | $1,905.46 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,630.78 / $4,466.84 / $4,570.88
| Professional | | $3,630.78 | $4,466.84 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,905.46 / $4,265.80
| Facility | | $524.81 | $1,905.46 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $616.60 / $11,481.54
| Facility | | $416.87 | $616.60 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,905.46 / $3,019.95 / $11,481.54
| Professional | | $1,905.46 | $3,019.95 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,882.50 / $29,512.09
| Facility | | $8,317.64 | $12,882.50 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $1,318.26 / $4,570.88
| Professional | | $416.87 | $1,318.26 | $4,570.88 |