- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $478.63 / $6,309.57
| Facility | | $125.89 | $478.63 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $218.78 / $489.78
| Professional | | $97.72 | $218.78 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $3,090.30 / $5,754.40
| Facility | | $2,238.72 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $302.00 / $831.76
| Professional | | $134.90 | $302.00 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $741.31 / $1,202.26
| Facility | | $645.65 | $741.31 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $346.74 / $912.01
| Professional | | $123.03 | $346.74 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $194.98 / $2,238.72
| Facility | | $93.33 | $194.98 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $323.59 / $645.65
| Professional | | $186.21 | $323.59 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $199.53 / $2,691.53
| Facility | | $93.33 | $199.53 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $489.78 / $1,737.80
| Professional | | $194.98 | $489.78 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $125.89
| Professional | | $32.36 | $33.11 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $380.19 / $870.96
| Professional | | $186.21 | $380.19 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,467.37 / $3,467.37
| Facility | | $1,862.09 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $537.03 / $1,659.59
| Professional | | $125.89 | $537.03 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $537.03 / $1,202.26
| Professional | | $323.59 | $537.03 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,818.38 / $4,677.35
| Facility | | $2,344.23 | $2,818.38 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $213.80 / $575.44
| Professional | | $100.00 | $213.80 | $575.44 |