- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,311.31 / $5,128.61
| Facility | | $1,778.28 | $3,311.31 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $812.83 / $3,019.95
| Professional | | $645.65 | $812.83 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $7,244.36 / $45,708.82
| Facility | | $1,659.59 | $7,244.36 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $1,096.48 / $6,918.31
| Professional | | $602.56 | $1,096.48 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $1,348.96 / $2,511.89
| Professional | | $741.31 | $1,348.96 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,380.38 / $7,079.46
| Facility | | $575.44 | $1,380.38 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $758.58 / $1,122.02
| Professional | | $389.05 | $758.58 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,165.95 / $13,182.57
| Facility | | $2,511.89 | $6,165.95 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $1,258.93 / $2,041.74
| Professional | | $660.69 | $1,258.93 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $7,585.78 / $45,708.82
| Facility | | $1,737.80 | $7,585.78 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $1,096.48 / $6,918.31
| Professional | | $602.56 | $1,096.48 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,309.57 / $13,489.63
| Facility | | $2,511.89 | $6,309.57 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $1,202.26 / $2,398.83
| Professional | | $776.25 | $1,202.26 | $2,398.83 |