- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,548.82 / $3,090.30
| Facility | | $467.74 | $1,548.82 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $537.03 / $1,348.96
| Professional | | $223.87 | $537.03 | $1,348.96 |
- 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
- $288.40 / $954.99 / $2,818.38
| Professional | | $288.40 | $954.99 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,570.40 / $4,168.69
| Facility | | $2,238.72 | $2,570.40 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $933.25 / $3,388.44
| Professional | | $295.12 | $933.25 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $776.25 / $3,162.28
| Facility | | $234.42 | $776.25 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $954.99 / $2,137.96
| Professional | | $416.87 | $954.99 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $812.83 / $3,630.78
| Facility | | $239.88 | $812.83 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $1,479.11 / $6,025.60
| Professional | | $794.33 | $1,479.11 | $6,025.60 |
- 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 / $1,071.52 / $2,951.21
| Professional | | $380.19 | $1,071.52 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $3,630.78
| Facility | | $2,454.71 | $2,454.71 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $1,445.44 / $5,623.41
| Professional | | $251.19 | $1,445.44 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $2,137.96 / $4,168.69
| Professional | | $851.14 | $2,137.96 | $4,168.69 |
- 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
- $257.04 / $794.33 / $2,041.74
| Professional | | $257.04 | $794.33 | $2,041.74 |