- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $3,090.30 / $11,220.18
| Facility | | $245.47 | $3,090.30 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $354.81 / $1,174.90
| Professional | | $239.88 | $354.81 | $1,174.90 |
- 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
- $239.88 / $467.74 / $1,122.02
| Professional | | $239.88 | $467.74 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $724.44 / $1,148.15
| Facility | | $616.60 | $724.44 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $776.25 / $870.96
| Professional | | $363.08 | $776.25 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $2,884.03 / $5,370.32
| Facility | | $263.03 | $2,884.03 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $602.56 / $741.31
| Professional | | $426.58 | $602.56 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $5,495.41 / $8,709.64
| Facility | | $263.03 | $5,495.41 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $436.52 / $2,089.30
| Professional | | $245.47 | $436.52 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $331.13
| Professional | | $32.36 | $33.11 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $549.54 / $933.25
| Professional | | $281.84 | $549.54 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,332.54 / $9,332.54
| Facility | | $6,309.57 | $9,332.54 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $1,202.26 / $2,089.30
| Professional | | $331.13 | $1,202.26 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $1,412.54 / $1,778.28
| Professional | | $588.84 | $1,412.54 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $398.11 / $1,047.13
| Professional | | $239.88 | $398.11 | $1,047.13 |