- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $2,951.21 / $7,762.47
| Facility | | $263.03 | $2,951.21 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $257.04 / $645.65
| Professional | | $158.49 | $257.04 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $234.42 / $616.60
| Professional | | $186.21 | $234.42 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $4,073.80
| Facility | | $229.09 | $229.09 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $371.54
| Professional | | $229.09 | $229.09 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $275.42 / $50,118.72
| Facility | | $34.67 | $275.42 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $302.00 / $741.31
| Professional | | $154.88 | $302.00 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $165.96 / $371.54
| Facility | | $79.43 | $165.96 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $363.08 / $562.34
| Professional | | $295.12 | $363.08 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $269.15 / $549.54
| Professional | | $181.97 | $269.15 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $50,118.72 / $75,857.76
| Facility | | $154.88 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $371.54 / $524.81
| Professional | | $302.00 | $371.54 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,630.27 / $4,897.79
| Facility | | $831.76 | $2,630.27 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $234.42 / $467.74
| Professional | | $141.25 | $234.42 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $223.87 / $512.86
| Facility | | $134.90 | $223.87 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $263.03 / $549.54
| Professional | | $181.97 | $263.03 | $549.54 |