- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $5,495.41 / $6,918.31
| Facility | | $1,071.52 | $5,495.41 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $1,380.38 / $4,265.80
| Professional | | $323.59 | $1,380.38 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $10,232.93 / $17,378.01
| Facility | | $5,495.41 | $10,232.93 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $2,089.30 / $2,511.89
| Professional | | $537.03 | $2,089.30 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $588.84 / $2,818.38
| Professional | | $416.87 | $588.84 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $4,265.80 / $7,244.36
| Facility | | $912.01 | $4,265.80 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $1,513.56 / $2,630.27
| Professional | | $426.58 | $1,513.56 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $12,882.50 / $18,197.01
| Facility | | $10,232.93 | $12,882.50 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $616.60 / $2,884.03
| Professional | | $562.34 | $616.60 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $1,202.26 / $13,489.63
| Professional | | $562.34 | $1,202.26 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $26,915.35 / $29,512.09
| Facility | | $11,748.98 | $26,915.35 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $1,230.27 / $2,630.27
| Professional | | $338.84 | $1,230.27 | $2,630.27 |