- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $17,782.79
| Facility | | $549.54 | $549.54 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $602.56 / $812.83
| Professional | | $512.86 | $602.56 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $8,709.64 / $11,220.18
| Facility | | $4,786.30 | $8,709.64 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $1,148.15 / $2,818.38
| Professional | | $575.44 | $1,148.15 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $831.76 / $1,318.26
| Facility | | $707.95 | $831.76 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $1,348.96 / $1,513.56
| Professional | | $562.34 | $1,348.96 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $831.76 / $6,918.31
| Facility | | $478.63 | $831.76 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $977.24 / $977.24
| Professional | | $977.24 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $831.76 / $11,481.54
| Facility | | $478.63 | $831.76 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $562.34 / $4,466.84
| Professional | | $316.23 | $562.34 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $363.08
| Professional | | $32.36 | $33.11 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,380.38 / $2,041.74
| Professional | | $851.14 | $1,380.38 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,513.56 / $9,549.93
| Facility | | $1,513.56 | $1,513.56 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,884.03 / $4,365.16
| Professional | | $1,122.02 | $2,884.03 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $1,174.90
| Professional | | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $1,995.26 / $2,454.71
| Professional | | $933.25 | $1,995.26 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $10,232.93 / $12,589.25
| Facility | | $6,309.57 | $10,232.93 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $478.63 / $1,318.26
| Professional | | $309.03 | $478.63 | $1,318.26 |