- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $5,011.87 / $8,709.64
| Facility | | $1,071.52 | $5,011.87 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $1,318.26 / $4,073.80
| Professional | | $288.40 | $1,318.26 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $5,370.32 / $17,782.79
| Facility | | $56.23 | $5,370.32 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $1,071.52 / $3,890.45
| Professional | | $302.00 | $1,071.52 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $758.58
| Facility | | $323.59 | $323.59 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $1,584.89 / $3,388.44
| Professional | | $478.63 | $1,584.89 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $1,659.59 / $3,715.35
| Professional | | $416.87 | $1,659.59 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $407.38 / $7,079.46
| Facility | | $177.83 | $407.38 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,995.26 / $3,548.13
| Professional | | $1,621.81 | $1,995.26 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,918.31 / $15,488.17
| Facility | | $2,570.40 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $1,348.96 / $3,467.37
| Professional | | $316.23 | $1,348.96 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $6,309.57
| Facility | | $1,122.02 | $1,122.02 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $588.84
| Professional | | $295.12 | $295.12 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $5,370.32 / $17,782.79
| Facility | | $56.23 | $5,370.32 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $1,071.52 / $3,890.45
| Professional | | $302.00 | $1,071.52 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $7,244.36 / $15,488.17
| Facility | | $2,570.40 | $7,244.36 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $1,584.89 / $3,801.89
| Professional | | $380.19 | $1,584.89 | $3,801.89 |