- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $938.83 / $4,981.39 / $16,713.00
| Facility | | $938.83 | $4,981.39 | $16,713.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.75 / $849.51 / $1,314.58
| Professional | | $190.75 | $849.51 | $1,314.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,143.00 / $5,863.00 / $11,400.00
| Facility | | $2,143.00 | $5,863.00 | $11,400.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.56 / $567.14 / $2,030.64
| Professional | | $229.56 | $567.14 | $2,030.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.00 / $100.00 / $6,848.26
| Facility | | $66.00 | $100.00 | $6,848.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.25 / $617.85 / $1,626.53
| Professional | | $180.25 | $617.85 | $1,626.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $745.75 / $881.34 / $2,076.36
| Facility | | $745.75 | $881.34 | $2,076.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.83 / $726.10 / $2,037.15
| Professional | | $180.83 | $726.10 | $2,037.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.53 / $710.35 / $1,065.53
| Professional | | $177.53 | $710.35 | $1,065.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.62 / $601.72 / $1,387.42
| Professional | | $161.62 | $601.72 | $1,387.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $787.27 / $1,330.15
| Facility | | $55.00 | $787.27 | $1,330.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,700.94 / $5,191.20 / $6,103.05
| Professional | | $2,700.94 | $5,191.20 | $6,103.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.12 / $752.15 / $1,346.61
| Facility | | $188.12 | $752.15 | $1,346.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.77 / $745.70 / $1,992.35
| Professional | | $186.77 | $745.70 | $1,992.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $528.41 / $528.41 / $2,503.55
| Professional | | $528.41 | $528.41 | $2,503.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.13 / $768.64 / $1,065.52
| Professional | | $162.13 | $768.64 | $1,065.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,523.00 / $7,384.00 / $16,148.00
| Facility | | $3,523.00 | $7,384.00 | $16,148.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $609.48 / $961.64 / $2,527.48
| Professional | | $609.48 | $961.64 | $2,527.48 |