- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $426.58 / $14,454.40
| Facility | | $229.09 | $426.58 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $309.03 / $758.58
| Professional | | $199.53 | $309.03 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $398.11 / $1,258.93
| Professional | | $213.80 | $398.11 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $630.96 / $1,000.00
| Facility | | $537.03 | $630.96 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $549.54 / $870.96
| Professional | | $245.47 | $549.54 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $346.74 / $3,090.30
| Facility | | $218.78 | $346.74 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $457.09 / $870.96
| Professional | | $363.08 | $457.09 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $389.05 / $9,772.37
| Facility | | $218.78 | $389.05 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $575.44 / $2,290.87
| Professional | | $234.42 | $575.44 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $478.63 / $870.96
| Professional | | $263.03 | $478.63 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,912.51 / $8,912.51
| Facility | | $6,165.95 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $1,548.82 / $2,290.87
| Professional | | $251.19 | $1,548.82 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $1,047.13 / $1,548.82
| Professional | | $524.81 | $1,047.13 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $12,589.25
| Facility | | $6,606.93 | $10,232.93 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $436.52 / $891.25
| Professional | | $218.78 | $436.52 | $891.25 |