- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $468.83 / $1,166.65 / $20,680.40
| Facility | | $468.83 | $1,166.65 | $20,680.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $375.95 / $468.83 / $1,060.97
| Professional | | $375.95 | $468.83 | $1,060.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $573.04 / $2,471.69
| Facility | | $55.00 | $573.04 | $2,471.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $607.76 / $1,062.11 / $3,841.05
| Professional | | $607.76 | $1,062.11 | $3,841.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.43 / $875.20 / $1,283.55
| Professional | | $509.43 | $875.20 | $1,283.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.21 / $845.07 / $1,039.86
| Facility | | $501.21 | $845.07 | $1,039.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.21 / $845.07 / $1,075.30
| Professional | | $501.21 | $845.07 | $1,075.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.44 / $400.16 / $867.00
| Professional | | $69.44 | $400.16 | $867.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.02 / $804.67 / $865.64
| Facility | | $587.02 | $804.67 | $865.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.04 / $573.04 / $590.44
| Facility | | $573.04 | $573.04 | $590.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $607.76 / $981.91 / $1,210.99
| Professional | | $607.76 | $981.91 | $1,210.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.42 / $849.36 / $1,144.07
| Professional | | $584.42 | $849.36 | $1,144.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.00 / $2,446.00 / $36,803.00
| Facility | | $703.00 | $2,446.00 | $36,803.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $538.13 / $847.00 / $1,239.70
| Professional | | $538.13 | $847.00 | $1,239.70 |