- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $484.31 / $7,920.26 / $59,023.00
| Facility | | $484.31 | $7,920.26 | $59,023.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.41 / $380.10 / $1,104.07
| Professional | | $209.41 | $380.10 | $1,104.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.80 / $2,400.80 / $3,250.41
| Facility | | $2,400.80 | $2,400.80 | $3,250.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.45 / $528.48 / $1,011.45
| Professional | | $291.45 | $528.48 | $1,011.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $420.55 / $602.04 / $922.44
| Professional | | $420.55 | $602.04 | $922.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.36 / $509.49 / $821.43
| Facility | | $271.36 | $509.49 | $821.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $348.58 / $522.58 / $905.82
| Professional | | $348.58 | $522.58 | $905.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.29 / $615.53 / $762.46
| Facility | | $362.29 | $615.53 | $762.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.97 / $574.55 / $979.09
| Facility | | $287.97 | $574.55 | $979.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $400.68 / $599.84 / $975.56
| Professional | | $400.68 | $599.84 | $975.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,382.73 / $10,185.20 / $12,751.18
| Facility | | $7,382.73 | $10,185.20 | $12,751.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.43 / $619.03 / $1,023.89
| Professional | | $405.43 | $619.03 | $1,023.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,533.00 / $8,090.00 / $12,786.00
| Facility | | $1,533.00 | $8,090.00 | $12,786.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $491.00 / $669.72 / $1,182.07
| Professional | | $491.00 | $669.72 | $1,182.07 |