- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $5,011.87 / $8,511.38
| Facility | | $549.54 | $5,011.87 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $537.03 / $4,168.69
| Professional | | $263.03 | $537.03 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $380.19 / $3,467.37
| Professional | | $223.87 | $380.19 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $3,162.28 / $6,760.83
| Facility | | $2,570.40 | $3,162.28 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $3,162.28 / $4,677.35
| Professional | | $363.08 | $3,162.28 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $831.76 / $7,244.36
| Professional | | $323.59 | $831.76 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $1,071.52 / $4,265.80
| Facility | | $251.19 | $1,071.52 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $5,623.41 / $17,782.79
| Professional | | $794.33 | $5,623.41 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $4,466.84 / $7,762.47
| Professional | | $575.44 | $4,466.84 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $4,466.84 / $5,888.44
| Professional | | $467.74 | $4,466.84 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,238.72 / $2,630.27
| Facility | | $2,238.72 | $2,238.72 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $645.65 / $7,244.36
| Professional | | $3.98 | $645.65 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $3,162.28 / $8,128.31
| Facility | | $1,479.11 | $3,162.28 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $794.33 / $5,888.44
| Professional | | $354.81 | $794.33 | $5,888.44 |