- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $4,241.22 / $13,841.56
| Facility | | $1,506.15 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.95 / $207.62 / $994.91
| Professional | | $64.95 | $207.62 | $994.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.18 / $79.18 / $151.43
| Professional | | $79.18 | $79.18 | $151.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,252.94 / $3,266.13 / $5,731.84
| Facility | | $2,252.94 | $3,266.13 | $5,731.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.76 / $154.03 / $1,084.05
| Professional | | $67.76 | $154.03 | $1,084.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.73 / $710.20 / $1,629.89
| Professional | | $125.73 | $710.20 | $1,629.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.20 / $554.71 / $1,169.77
| Facility | | $67.20 | $554.71 | $1,169.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $838.64 / $1,384.87 / $4,244.64
| Professional | | $838.64 | $1,384.87 | $4,244.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.78 / $1,213.97 / $1,641.89
| Facility | | $169.78 | $1,213.97 | $1,641.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.66 / $1,060.82 / $1,592.05
| Professional | | $150.66 | $1,060.82 | $1,592.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $751.80 / $1,704.10
| Professional | | $4.00 | $751.80 | $1,704.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $838.64 / $1,303.24 / $1,565.45
| Professional | | $838.64 | $1,303.24 | $1,565.45 |