- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $3,630.78 / $12,022.64
| Facility | | $323.59 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $398.11 / $1,380.38
| Professional | | $158.49 | $398.11 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $18,620.87 / $35,481.34
| Facility | | $13,803.84 | $18,620.87 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $676.08 / $1,778.28
| Professional | | $346.74 | $676.08 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,000.00 / $1,698.24
| Facility | | $870.96 | $1,000.00 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $1,318.26 / $1,479.11
| Professional | | $524.81 | $1,318.26 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $691.83 / $3,981.07
| Facility | | $331.13 | $691.83 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $794.33 / $1,023.29
| Professional | | $588.84 | $794.33 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $758.58 / $23,988.33
| Facility | | $346.74 | $758.58 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $691.83 / $13,489.63
| Professional | | $389.05 | $691.83 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $758.58 / $1,148.15
| Professional | | $501.19 | $758.58 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $100,000.00 / $147,910.84
| Facility | | $50,118.72 | $100,000.00 | $147,910.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $14,791.08
| Facility | AS | $10,000.00 | $10,000.00 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,698.24 / $13,489.63
| Professional | | $630.96 | $1,698.24 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,949.84 / $2,290.87
| Professional | | $1,288.25 | $1,949.84 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $20,892.96 / $27,542.29
| Facility | | $10,964.78 | $20,892.96 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $575.44 / $1,479.11
| Professional | | $371.54 | $575.44 | $1,479.11 |