- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $316.23 / $1,905.46
| Facility | | $169.82 | $316.23 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $173.78 / $457.09
| Professional | | $144.54 | $173.78 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $354.81 / $812.83
| Professional | | $181.97 | $354.81 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $575.44 / $912.01
| Facility | | $489.78 | $575.44 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $467.74 / $630.96
| Professional | | $234.42 | $467.74 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $316.23 / $3,801.89
| Facility | | $154.88 | $316.23 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $426.58 / $501.19
| Professional | | $316.23 | $426.58 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $371.54 / $8,317.64
| Facility | | $141.25 | $371.54 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $288.40 / $1,380.38
| Professional | | $165.96 | $288.40 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $190.55
| Professional | | $32.36 | $33.11 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $426.58 / $602.56
| Professional | | $218.78 | $426.58 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $9,549.93 / $9,549.93
| Facility | | $6,456.54 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $436.52 / $1,318.26
| Professional | | $190.55 | $436.52 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $851.14 / $1,000.00
| Professional | | $354.81 | $851.14 | $1,000.00 |
- 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
- $141.25 / $245.47 / $645.65
| Professional | | $141.25 | $245.47 | $645.65 |