- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.91 / $2,769.52 / $14,464.32
| Facility | | $295.91 | $2,769.52 | $14,464.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.28 / $344.79 / $965.07
| Professional | | $220.28 | $344.79 | $965.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,239.30 / $9,011.04 / $12,000.00
| Facility | | $2,239.30 | $9,011.04 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.63 / $522.53 / $2,287.00
| Professional | | $346.63 | $522.53 | $2,287.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.83 / $568.48 / $3,763.00
| Facility | | $466.83 | $568.48 | $3,763.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.74 / $457.66 / $692.57
| Professional | | $277.74 | $457.66 | $692.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.40 / $789.52 / $3,442.03
| Facility | | $358.40 | $789.52 | $3,442.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.05 / $732.35 / $2,535.34
| Professional | | $358.05 | $732.35 | $2,535.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.79 / $363.75 / $615.73
| Professional | | $60.79 | $363.75 | $615.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $361.34 / $440.86 / $737.00
| Facility | | $361.34 | $440.86 | $737.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.62 / $1,256.68 / $2,239.30
| Facility | | $297.62 | $1,256.68 | $2,239.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.30 / $501.59 / $601.54
| Professional | | $316.30 | $501.59 | $601.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,650.51 / $9,027.82 / $17,177.93
| Facility | | $5,650.51 | $9,027.82 | $17,177.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.49 / $433.68 / $591.02
| Professional | | $351.49 | $433.68 | $591.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $2,937.00 / $11,941.00
| Facility | | $1,300.00 | $2,937.00 | $11,941.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.41 / $461.84 / $648.91
| Professional | | $269.41 | $461.84 | $648.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.93 / $226.24 / $226.24
| Professional | | $181.93 | $226.24 | $226.24 |