- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.28 / $1,181.00 / $8,093.25
| Facility | | $191.28 | $1,181.00 | $8,093.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.52 / $223.83 / $381.37
| Professional | | $157.52 | $223.83 | $381.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.47 / $1,657.11 / $2,812.07
| Facility | | $1,506.47 | $1,657.11 | $2,812.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.03 / $338.29 / $595.66
| Professional | | $232.03 | $338.29 | $595.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.24 / $1,359.55 / $2,702.90
| Facility | | $453.24 | $1,359.55 | $2,702.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.31 / $290.97 / $511.65
| Professional | | $191.31 | $290.97 | $511.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.65 / $278.67 / $397.14
| Facility | | $161.65 | $278.67 | $397.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.00 / $534.00 / $1,107.11
| Professional | | $323.00 | $534.00 | $1,107.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.80 / $333.80 / $524.70
| Professional | | $286.80 | $333.80 | $524.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.00 / $1,208.00 / $9,324.00
| Facility | | $773.00 | $1,208.00 | $9,324.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.36 / $269.81 / $549.14
| Professional | | $193.36 | $269.81 | $549.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,153.08 / $1,153.08 / $16,394.00
| Facility | | $1,153.08 | $1,153.08 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,217.52 / $1,972.58 / $2,081.96
| Professional | | $1,217.52 | $1,972.58 | $2,081.96 |