- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.54 / $673.60 / $14,464.32
| Facility | | $171.54 | $673.60 | $14,464.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.47 / $239.20 / $591.05
| Professional | | $89.47 | $239.20 | $591.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.13 / $7,780.40 / $12,000.00
| Facility | | $606.13 | $7,780.40 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.01 / $601.91 / $2,421.44
| Professional | | $153.01 | $601.91 | $2,421.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.83 / $568.48 / $3,311.26
| Facility | | $466.83 | $568.48 | $3,311.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.73 / $297.27 / $929.08
| Professional | | $124.73 | $297.27 | $929.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.62 / $339.30 / $2,495.04
| Facility | | $126.62 | $339.30 | $2,495.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.65 / $282.18 / $1,013.56
| Professional | | $124.65 | $282.18 | $1,013.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.66 / $547.91 / $932.60
| Professional | | $88.66 | $547.91 | $932.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.70 / $531.38 / $664.64
| Facility | | $268.70 | $531.38 | $664.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.34 / $929.09 / $1,915.04
| Facility | | $453.34 | $929.09 | $1,915.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.13 / $386.10 / $875.58
| Professional | | $156.13 | $386.10 | $875.58 |
- 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
- $158.99 / $372.96 / $767.81
| Professional | | $158.99 | $372.96 | $767.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,100.00 / $2,431.00 / $8,535.00
| Facility | | $1,100.00 | $2,431.00 | $8,535.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.26 / $534.00 / $977.09
| Professional | | $325.26 | $534.00 | $977.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.83 / $266.95 / $368.39
| Professional | | $100.83 | $266.95 | $368.39 |