- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $371.54 / $5,754.40
| Facility | | $141.25 | $371.54 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $158.49 / $295.12
| Professional | | $87.10 | $158.49 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,570.88 / $7,079.46
| Facility | | $2,344.23 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $213.80 / $489.78
| Professional | | $138.04 | $213.80 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $575.44 / $912.01
| Facility | | $489.78 | $575.44 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $380.19 / $794.33
| Professional | | $154.88 | $380.19 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $263.03 / $3,981.07
| Facility | | $104.71 | $263.03 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $316.23 / $501.19
| Professional | | $204.17 | $316.23 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $275.42 / $5,248.07
| Facility | | $112.20 | $275.42 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $467.74 / $2,818.38
| Professional | | $181.97 | $467.74 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $223.87
| Professional | | $32.36 | $33.11 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $288.40 / $602.56
| Professional | | $151.36 | $288.40 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,818.38 / $2,818.38
| Facility | | $1,905.46 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $446.68 / $2,884.03
| Professional | | $154.88 | $446.68 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $933.25 / $1,778.28
| Professional | | $436.52 | $933.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,630.78 / $6,456.54
| Facility | | $2,884.03 | $3,630.78 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $234.42 / $707.95
| Professional | | $107.15 | $234.42 | $707.95 |