- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.14 / $2,291.00 / $18,711.00
| Facility | | $447.14 | $2,291.00 | $18,711.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.98 / $337.41 / $652.17
| Professional | | $212.98 | $337.41 | $652.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $6,920.96 / $10,512.09
| Facility | | $55.00 | $6,920.96 | $10,512.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.74 / $649.71 / $2,410.58
| Professional | | $376.74 | $649.71 | $2,410.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $870.49 / $3,311.26
| Facility | | $500.00 | $870.49 | $3,311.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.66 / $478.70 / $833.81
| Professional | | $279.66 | $478.70 | $833.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.77 / $516.15 / $3,028.83
| Facility | | $269.77 | $516.15 | $3,028.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.93 / $491.09 / $2,230.98
| Professional | | $248.93 | $491.09 | $2,230.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.24 / $421.81 / $731.83
| Professional | | $70.24 | $421.81 | $731.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.97 / $472.60 / $550.74
| Facility | | $319.97 | $472.60 | $550.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.46 / $929.09 / $1,915.04
| Facility | | $371.46 | $929.09 | $1,915.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.88 / $623.17 / $752.17
| Professional | | $387.88 | $623.17 | $752.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,159.74 / $7,956.97 / $15,220.78
| Facility | | $5,159.74 | $7,956.97 | $15,220.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $438.70 / $540.38 / $709.30
| Professional | | $438.70 | $540.38 | $709.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.00 / $1,120.00 / $6,857.00
| Facility | | $650.00 | $1,120.00 | $6,857.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.30 / $459.01 / $778.06
| Professional | | $267.30 | $459.01 | $778.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.24 / $304.72 / $304.72
| Professional | | $230.24 | $304.72 | $304.72 |