- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.98 / $2,789.83 / $14,482.00
| Facility | | $292.98 | $2,789.83 | $14,482.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.36 / $521.09 / $3,088.97
| Professional | | $267.36 | $521.09 | $3,088.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.00 / $3,193.00 / $5,962.00
| Facility | | $1,905.00 | $3,193.00 | $5,962.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $324.64 / $808.32 / $2,712.45
| Professional | | $324.64 | $808.32 | $2,712.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,643.96 / $7,763.99 / $11,910.16
| Facility | | $6,643.96 | $7,763.99 | $11,910.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.71 / $1,089.79 / $10,034.66
| Professional | | $427.71 | $1,089.79 | $10,034.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.25 / $684.00 / $4,184.18
| Facility | | $268.25 | $684.00 | $4,184.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.36 / $2,270.63 / $4,821.00
| Facility | | $267.36 | $2,270.63 | $4,821.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $740.70 / $6,463.00 / $17,828.88
| Professional | | $740.70 | $6,463.00 | $17,828.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.00 / $3,456.24 / $5,599.43
| Professional | | $85.00 | $3,456.24 | $5,599.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.25 / $684.00 / $4,184.18
| Facility | | $268.25 | $684.00 | $4,184.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $596.69 / $2,483.73 / $7,841.32
| Professional | | $596.69 | $2,483.73 | $7,841.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.13 / $3,880.05 / $3,880.05
| Facility | | $454.13 | $3,880.05 | $3,880.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.37 / $8,965.95 / $17,828.88
| Professional | | $510.37 | $8,965.95 | $17,828.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,171.04 / $9,628.53 / $12,371.43
| Professional | | $1,171.04 | $9,628.53 | $12,371.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,976.00 / $3,827.00 / $5,471.00
| Facility | | $2,976.00 | $3,827.00 | $5,471.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $740.70 / $4,393.71 / $12,791.36
| Professional | | $740.70 | $4,393.71 | $12,791.36 |