- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $2,691.53 / $4,677.35
| Facility | | $758.58 | $2,691.53 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $870.96 / $2,089.30
| Professional | | $660.69 | $870.96 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $3,019.95 / $6,918.31
| Facility | | $239.88 | $3,019.95 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $1,202.26 / $2,884.03
| Professional | | $489.78 | $1,202.26 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $208.93 / $295.12
| Facility | | $165.96 | $208.93 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $1,380.38 / $2,951.21
| Facility | | $67.61 | $1,380.38 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $1,288.25 / $1,621.81
| Professional | | $562.34 | $1,288.25 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,548.82 / $1,548.82 / $1,819.70
| Professional | | $1,548.82 | $1,548.82 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $1,258.93 / $2,137.96
| Professional | | $501.19 | $1,258.93 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,584.89 / $1,584.89
| Facility | | $1,584.89 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $3,162.28 / $6,918.31
| Facility | | $239.88 | $3,162.28 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $1,230.27 / $2,884.03
| Professional | | $537.03 | $1,230.27 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $309.03 / $741.31
| Facility | | $57.54 | $309.03 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $831.76 / $1,778.28
| Professional | | $323.59 | $831.76 | $1,778.28 |