- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,035.08 / $5,382.00 / $17,054.00
| Facility | | $1,035.08 | $5,382.00 | $17,054.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.26 / $151.88 / $932.51
| Professional | | $140.26 | $151.88 | $932.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,275.00 / $5,944.00 / $11,994.00
| Facility | | $2,275.00 | $5,944.00 | $11,994.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.02 / $298.13 / $573.94
| Professional | | $236.02 | $298.13 | $573.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.20 / $100.00 / $9,907.12
| Facility | | $64.20 | $100.00 | $9,907.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.85 / $170.22 / $425.64
| Professional | | $112.85 | $170.22 | $425.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.15 / $223.88 / $613.60
| Professional | | $160.15 | $223.88 | $613.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.28 / $185.73 / $222.88
| Professional | | $133.28 | $185.73 | $222.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $167.16 / $217.46 / $388.75
| Professional | | $167.16 | $217.46 | $388.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $381.84 / $826.36
| Facility | | $55.00 | $381.84 | $826.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,219.83 / $1,257.76 / $1,434.98
| Professional | | $1,219.83 | $1,257.76 | $1,434.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.03 / $208.76 / $297.17
| Facility | | $164.03 | $208.76 | $297.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.13 / $224.28 / $500.34
| Professional | | $162.13 | $224.28 | $500.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $578.59 / $578.59 / $578.59
| Professional | | $578.59 | $578.59 | $578.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.28 / $186.60 / $226.58
| Professional | | $133.28 | $186.60 | $226.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.00 / $1,551.00 / $6,920.00
| Facility | | $548.00 | $1,551.00 | $6,920.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.47 / $206.79 / $557.76
| Professional | | $144.47 | $206.79 | $557.76 |