- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.63 / $2,619.51 / $9,490.75
| Facility | | $159.63 | $2,619.51 | $9,490.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.78 / $628.97 / $3,352.32
| Professional | | $150.78 | $628.97 | $3,352.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,538.00 / $9,720.00 / $15,579.70
| Facility | | $6,538.00 | $9,720.00 | $15,579.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.27 / $1,675.96 / $13,712.93
| Professional | | $235.27 | $1,675.96 | $13,712.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,405.40 / $8,653.79 / $13,958.27
| Facility | | $7,405.40 | $8,653.79 | $13,958.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.18 / $3,400.48 / $8,948.08
| Professional | | $285.18 | $3,400.48 | $8,948.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.63 / $344.71 / $4,466.14
| Facility | | $159.63 | $344.71 | $4,466.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.54 / $4,635.00 / $15,126.00
| Facility | | $172.54 | $4,635.00 | $15,126.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,982.05 / $7,131.80 / $18,111.91
| Professional | | $2,982.05 | $7,131.80 | $18,111.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.00 / $2,250.54 / $6,603.89
| Professional | | $70.00 | $2,250.54 | $6,603.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.63 / $344.71 / $4,466.14
| Facility | | $159.63 | $344.71 | $4,466.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.45 / $2,478.33 / $8,699.83
| Professional | | $385.45 | $2,478.33 | $8,699.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,213.32 / $1,213.32 / $1,213.32
| Facility | | $1,213.32 | $1,213.32 | $1,213.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.39 / $1,286.56 / $19,789.59
| Professional | | $239.39 | $1,286.56 | $19,789.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $559.27 / $964.80 / $15,381.29
| Professional | | $559.27 | $964.80 | $15,381.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,301.00 / $11,608.00 / $13,980.00
| Facility | | $7,301.00 | $11,608.00 | $13,980.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,400.53 / $9,957.42 / $14,314.02
| Professional | | $3,400.53 | $9,957.42 | $14,314.02 |