- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,822.85 / $4,915.35 / $7,254.58
| Facility | | $2,822.85 | $4,915.35 | $7,254.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $529.44 / $2,822.85 / $3,491.96
| Professional | | $529.44 | $2,822.85 | $3,491.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,469.99 / $6,850.25 / $7,819.13
| Facility | | $6,469.99 | $6,850.25 | $7,819.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.98 / $257.98 / $1,419.53
| Professional | | $193.98 | $257.98 | $1,419.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.10 / $197.30 / $341.32
| Facility | | $37.10 | $197.30 | $341.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.02 / $212.77 / $252.79
| Professional | | $40.02 | $212.77 | $252.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.35 / $5,136.28 / $9,015.54
| Facility | | $431.35 | $5,136.28 | $9,015.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.49 / $331.24 / $567.51
| Professional | | $222.49 | $331.24 | $567.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.35 / $5,136.28 / $9,015.54
| Facility | | $431.35 | $5,136.28 | $9,015.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.21 / $328.31 / $548.64
| Professional | | $225.21 | $328.31 | $548.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.00 / $42.05 / $109.66
| Professional | | $31.00 | $42.05 | $109.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,326.58 / $2,379.01 / $2,527.96
| Facility | | $2,326.58 | $2,379.01 | $2,527.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.45 / $1,594.67 / $3,345.50
| Professional | | $254.45 | $1,594.67 | $3,345.50 |