- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.02 / $1,016.46 / $14,482.00
| Facility | | $149.02 | $1,016.46 | $14,482.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.29 / $676.00 / $1,305.80
| Professional | | $130.29 | $676.00 | $1,305.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,139.00 / $2,419.00 / $4,441.52
| Facility | | $1,139.00 | $2,419.00 | $4,441.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.42 / $866.69 / $4,270.03
| Professional | | $197.42 | $866.69 | $4,270.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,074.38 / $2,424.08 / $3,718.59
| Facility | | $2,074.38 | $2,424.08 | $3,718.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.32 / $547.70 / $3,015.51
| Professional | | $210.32 | $547.70 | $3,015.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.28 / $690.62 / $1,464.13
| Facility | | $134.28 | $690.62 | $1,464.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.28 / $756.56 / $3,242.00
| Facility | | $134.28 | $756.56 | $3,242.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $917.35 / $2,821.89 / $5,607.84
| Professional | | $917.35 | $2,821.89 | $5,607.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.00 / $1,076.06 / $1,832.95
| Professional | | $85.00 | $1,076.06 | $1,832.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.88 / $684.04 / $1,464.13
| Facility | | $134.88 | $684.04 | $1,464.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $298.72 / $793.50 / $2,505.13
| Professional | | $298.72 | $793.50 | $2,505.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.35 / $1,221.34 / $1,221.34
| Facility | | $230.35 | $1,221.34 | $1,221.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.08 / $2,821.89 / $5,607.84
| Professional | | $256.08 | $2,821.89 | $5,607.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $514.71 / $2,705.56 / $3,879.11
| Professional | | $514.71 | $2,705.56 | $3,879.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,883.00 / $3,242.00 / $6,438.00
| Facility | | $2,883.00 | $3,242.00 | $6,438.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.36 / $1,751.24 / $3,843.93
| Professional | | $891.36 | $1,751.24 | $3,843.93 |