- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $524.81 / $14,454.40
| Facility | | $281.84 | $524.81 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $281.84 / $501.19
| Professional | | $239.88 | $281.84 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $10,232.93 / $17,378.01
| Facility | | $4,677.35 | $10,232.93 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $489.78 / $1,258.93
| Professional | | $257.04 | $489.78 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $776.25 / $1,230.27
| Facility | | $660.69 | $776.25 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $575.44 / $1,071.52
| Professional | | $269.15 | $575.44 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $331.13 / $3,162.28
| Facility | | $245.47 | $331.13 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $562.34 / $870.96
| Professional | | $446.68 | $562.34 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $354.81 / $5,248.07
| Facility | | $245.47 | $354.81 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $426.58 / $1,905.46
| Professional | | $263.03 | $426.58 | $1,905.46 |
- 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
- $295.12 / $537.03 / $831.76
| Professional | | $295.12 | $537.03 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $10,471.29 / $15,488.17
| Facility | | $10,471.29 | $10,471.29 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $912.01 / $1,862.09
| Professional | | $257.04 | $912.01 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $954.99 / $954.99
| Professional | | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $1,288.25 / $1,445.44
| Professional | | $954.99 | $1,288.25 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,606.93
| Facility | | $2,884.03 | $3,801.89 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $371.54 / $1,000.00
| Professional | | $251.19 | $371.54 | $1,000.00 |