- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $3,162.28 / $8,317.64
| Facility | | $234.42 | $3,162.28 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $363.08 / $1,122.02
| Professional | | $204.17 | $363.08 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $407.38 / $1,023.29
| Professional | | $204.17 | $407.38 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $660.69 / $1,071.52
| Facility | | $562.34 | $660.69 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $457.09 / $912.01
| Professional | | $218.78 | $457.09 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $281.84 / $5,248.07
| Facility | | $199.53 | $281.84 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $467.74 / $676.08
| Professional | | $380.19 | $467.74 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $331.13 / $7,762.47
| Facility | | $208.93 | $331.13 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $363.08 / $1,584.89
| Professional | | $204.17 | $363.08 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $457.09 / $707.95
| Professional | | $251.19 | $457.09 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,943.28 / $7,943.28
| Facility | | $5,370.32 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $1,000.00 / $1,584.89
| Professional | | $218.78 | $1,000.00 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $776.25 / $776.25
| Professional | | $776.25 | $776.25 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $794.33 / $1,096.48
| Professional | | $501.19 | $794.33 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $288.40 / $776.25
| Professional | | $194.98 | $288.40 | $776.25 |