- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $302.00 / $3,090.30
| Facility | | $158.49 | $302.00 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $165.96 / $426.58
| Professional | | $128.82 | $165.96 | $426.58 |
- 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
- $173.78 / $338.84 / $776.25
| Professional | | $173.78 | $338.84 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $549.54 / $891.25
| Facility | | $467.74 | $549.54 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $446.68 / $616.60
| Professional | | $218.78 | $446.68 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $288.40 / $4,168.69
| Facility | | $158.49 | $288.40 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $398.11 / $478.63
| Professional | | $309.03 | $398.11 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $346.74 / $8,317.64
| Facility | | $154.88 | $346.74 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $251.19 / $1,548.82
| Professional | | $154.88 | $251.19 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $181.97
| Professional | | $32.36 | $33.11 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $407.38 / $575.44
| Professional | | $213.80 | $407.38 | $575.44 |
- 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
- $181.97 / $416.87 / $1,548.82
| Professional | | $181.97 | $416.87 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $794.33 / $977.24
| Professional | | $331.13 | $794.33 | $977.24 |
- 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
- $128.82 / $239.88 / $588.84
| Professional | | $128.82 | $239.88 | $588.84 |