- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,187.76 / $6,025.60
| Facility | | $512.86 | $2,187.76 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $1,584.89 / $3,235.94
| Professional | | $436.52 | $1,584.89 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $13,182.57 / $21,877.62
| Facility | | $9,772.37 | $13,182.57 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $2,398.83 / $7,585.78
| Professional | | $707.95 | $2,398.83 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $5,248.07 / $8,511.38
| Facility | | $4,570.88 | $5,248.07 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $1,621.81 / $6,025.60
| Professional | | $758.58 | $1,621.81 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $6,165.95 / $13,489.63
| Facility | | $512.86 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $1,479.11 / $4,786.30
| Professional | | $977.24 | $1,479.11 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $8,709.64 / $17,378.01
| Facility | | $478.63 | $8,709.64 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,128.61 / $11,220.18
| Professional | | $2,344.23 | $5,128.61 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $50.12 / $3,162.28
| Professional | | $32.36 | $50.12 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,905.46 / $5,623.41
| Professional | | $851.14 | $1,905.46 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,708.82 / $45,708.82 / $67,608.30
| Facility | | $45,708.82 | $45,708.82 | $67,608.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $6,606.93 / $16,595.87
| Professional | | $758.58 | $6,606.93 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,238.72 / $3,235.94 / $12,302.69
| Professional | | $2,238.72 | $3,235.94 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $17,782.79
| Facility | | $8,912.51 | $13,803.84 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $2,137.96 / $7,943.28
| Professional | | $549.54 | $2,137.96 | $7,943.28 |