- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,311.31 / $5,128.61
| Facility | | $1,778.28 | $3,311.31 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $213.80 / $537.03
| Professional | | $181.97 | $213.80 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $3,981.07 / $45,708.82
| Facility | | $489.78 | $3,981.07 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $302.00 / $1,445.44
| Professional | | $181.97 | $302.00 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $1,659.59 / $1,659.59
| Professional | | $691.83 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $3,090.30
| Facility | | $676.08 | $741.31 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $295.12 / $549.54
| Professional | | $190.55 | $295.12 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $575.44 / $7,079.46
| Facility | | $186.21 | $575.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $269.15 / $407.38
| Professional | | $190.55 | $269.15 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $338.84 / $512.86
| Professional | | $186.21 | $338.84 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $3,981.07 / $45,708.82
| Facility | | $489.78 | $3,981.07 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $302.00 / $1,445.44
| Professional | | $186.21 | $302.00 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,890.45 / $9,549.93
| Facility | | $1,071.52 | $3,890.45 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $288.40 / $562.34
| Professional | | $181.97 | $288.40 | $562.34 |