- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,098.00 / $5,463.36 / $12,765.09
| Facility | | $1,098.00 | $5,463.36 | $12,765.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.43 / $305.47 / $1,287.68
| Professional | | $228.43 | $305.47 | $1,287.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.73 / $171.73 / $205.36
| Professional | | $171.73 | $171.73 | $205.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,904.89 / $9,357.90 / $17,567.16
| Facility | | $6,904.89 | $9,357.90 | $17,567.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.87 / $433.72 / $621.07
| Professional | | $241.87 | $433.72 | $621.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.53 / $736.54 / $944.62
| Professional | | $557.53 | $736.54 | $944.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.25 / $519.29 / $4,766.80
| Facility | | $291.25 | $519.29 | $4,766.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $403.51 / $761.39 / $2,466.08
| Professional | | $403.51 | $761.39 | $2,466.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.59 / $752.05 / $2,691.59
| Facility | | $562.59 | $752.05 | $2,691.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.06 / $666.07 / $910.35
| Professional | | $487.06 | $666.07 | $910.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.60 / $440.90 / $609.19
| Professional | | $328.60 | $440.90 | $609.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $434.55 / $723.33 / $871.97
| Professional | | $434.55 | $723.33 | $871.97 |