- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $741.31 / $14,454.40
| Facility | | $95.50 | $741.31 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $173.78 / $776.25
| Professional | | $83.18 | $173.78 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $389.05 / $1,584.89
| Professional | | $107.15 | $389.05 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,187.76 / $3,548.13
| Facility | | $1,905.46 | $2,187.76 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $457.09 / $2,041.74
| Professional | | $125.89 | $457.09 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $173.78 / $851.14
| Facility | | $83.18 | $173.78 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $281.84 / $1,659.59
| Professional | | $162.18 | $281.84 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $239.88 / $2,818.38
| Facility | | $85.11 | $239.88 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $1,000.00 / $4,677.35
| Professional | | $234.42 | $1,000.00 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $114.82
| Professional | | $32.36 | $33.11 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $338.84 / $2,089.30
| Professional | | $141.25 | $338.84 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $2,041.74 / $2,041.74
| Facility | | $208.93 | $2,041.74 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $2,754.23 / $4,677.35
| Professional | | $114.82 | $2,754.23 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $112.20 / $891.25
| Professional | | $112.20 | $112.20 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $537.03 / $3,548.13
| Professional | | $229.09 | $537.03 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,897.79 / $19,498.45
| Facility | | $1,995.26 | $4,897.79 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $288.40 / $1,380.38
| Professional | | $112.20 | $288.40 | $1,380.38 |