- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $4,786.30 / $5,370.32
| Facility | | $158.49 | $4,786.30 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $1,905.46 / $5,623.41
| Professional | | $151.36 | $1,905.46 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $17,378.01
| Facility | | $6,606.93 | $10,964.78 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $1,659.59 / $10,232.93
| Professional | | $218.78 | $1,659.59 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $8,709.64 / $13,803.84
| Facility | | $7,413.10 | $8,709.64 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $812.83 / $9,120.11
| Professional | | $275.42 | $812.83 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $3,981.07 / $7,413.10
| Facility | | $186.21 | $3,981.07 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $524.81 / $7,762.47
| Professional | | $363.08 | $524.81 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $7,244.36 / $15,848.93
| Facility | | $186.21 | $7,244.36 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,370.32 / $15,848.93
| Professional | | $2,344.23 | $5,370.32 | $15,848.93 |
- 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
- $239.88 / $2,818.38 / $8,511.38
| Professional | | $239.88 | $2,818.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $16,218.10 / $23,988.33
| Facility | | $16,218.10 | $16,218.10 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $4,786.30 / $18,620.87
| Professional | | $234.42 | $4,786.30 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $954.99 / $15,488.17
| Professional | | $524.81 | $954.99 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $12,302.69 / $16,218.10
| Facility | | $7,585.78 | $12,302.69 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $2,454.71 / $11,481.54
| Professional | | $204.17 | $2,454.71 | $11,481.54 |