- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $2,454.71 / $5,128.61
| Facility | | $223.87 | $2,454.71 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $537.03 / $4,365.16
| Professional | | $263.03 | $537.03 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,754.23 / $5,370.32
| Facility | | $1,698.24 | $2,754.23 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $1,995.26 / $7,762.47
| Professional | | $478.63 | $1,995.26 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $9,332.54 / $22,387.21
| Facility | | $5,754.40 | $9,332.54 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $549.54 / $549.54 / $549.54
| Facility | 22 | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $1,318.26 / $9,549.93
| Professional | | $537.03 | $1,318.26 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $8,912.51 / $17,378.01
| Facility | | $7,079.46 | $8,912.51 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $1,778.28 / $8,317.64
| Professional | | $575.44 | $1,778.28 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,995.26 / $5,370.32
| Facility | | $295.12 | $1,995.26 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,949.84 / $5,754.40 / $17,782.79
| Professional | | $1,949.84 | $5,754.40 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $3,090.30 / $6,456.54
| Facility | | $1,230.27 | $3,090.30 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $1,380.38 / $7,943.28
| Professional | | $309.03 | $1,380.38 | $7,943.28 |