- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $1,905.46 / $8,317.64
| Facility | | $263.03 | $1,905.46 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $512.86 / $3,981.07
| Professional | | $234.42 | $512.86 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $2,089.30 / $8,912.51
| Professional | | $323.59 | $2,089.30 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $12,022.64
| Facility | | $6,456.54 | $7,585.78 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $1,000.00 / $9,772.37
| Professional | | $316.23 | $1,000.00 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $2,137.96 / $4,073.80
| Facility | | $239.88 | $2,137.96 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $1,000.00 / $6,025.60
| Professional | | $436.52 | $1,000.00 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $2,290.87 / $4,786.30
| Facility | | $245.47 | $2,290.87 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $4,677.35 / $17,378.01
| Professional | | $602.56 | $4,677.35 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $2,754.23 / $8,511.38
| Professional | | $380.19 | $2,754.23 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $6,918.31
| Facility | | $2,454.71 | $2,454.71 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $3,467.37 / $16,218.10
| Professional | | $257.04 | $3,467.37 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $870.96 / $9,332.54
| Professional | | $870.96 | $870.96 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $7,079.46 / $12,882.50
| Professional | | $1,047.13 | $7,079.46 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,630.78 / $6,456.54
| Facility | | $2,884.03 | $3,630.78 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $707.95 / $6,309.57
| Professional | | $263.03 | $707.95 | $6,309.57 |