- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.45 / $967.81 / $1,841.85
| Facility | | $240.45 | $967.81 | $1,841.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.87 / $240.45 / $1,818.92
| Professional | | $183.87 | $240.45 | $1,818.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.00 / $1,215.13 / $3,335.15
| Facility | | $312.00 | $1,215.13 | $3,335.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.57 / $152.07 / $477.60
| Professional | | $142.57 | $152.07 | $477.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $373.40 / $2,537.42
| Facility | | $59.40 | $373.40 | $2,537.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.71 / $183.87 / $522.79
| Professional | | $128.71 | $183.87 | $522.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.33 / $1,134.50 / $2,264.61
| Facility | | $435.33 | $1,134.50 | $2,264.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.28 / $591.41 / $1,306.94
| Professional | | $360.28 | $591.41 | $1,306.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.50 / $744.15 / $913.28
| Professional | | $676.50 | $744.15 | $913.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $608.85 / $777.98 / $1,319.18
| Professional | | $608.85 | $777.98 | $1,319.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,177.10 / $3,213.38 / $3,213.38
| Facility | | $1,177.10 | $3,213.38 | $3,213.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,368.97 / $3,368.97 / $5,073.75
| Professional | | $3,368.97 | $3,368.97 | $5,073.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.58 / $811.80 / $1,794.98
| Facility | | $319.58 | $811.80 | $1,794.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.17 / $744.15 / $1,306.94
| Professional | | $311.17 | $744.15 | $1,306.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $992.90 / $992.90 / $992.90
| Professional | | $992.90 | $992.90 | $992.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.81 / $128.71 / $727.85
| Professional | | $118.81 | $128.71 | $727.85 |