- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.34 / $1,206.89 / $2,163.29
| Facility | | $531.34 | $1,206.89 | $2,163.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.30 / $499.08 / $645.19
| Professional | | $402.30 | $499.08 | $645.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $759.05 / $759.05 / $1,973.53
| Facility | | $759.05 | $759.05 | $1,973.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.20 / $106.20 / $1,554.91
| Professional | | $106.20 | $106.20 | $1,554.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $759.05 / $759.05 / $759.05
| Facility | | $759.05 | $759.05 | $759.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $554.11 / $759.05 / $759.05
| Professional | | $554.11 | $759.05 | $759.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $910.86 / $1,536.91 / $1,969.39
| Facility | | $910.86 | $1,536.91 | $1,969.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.04 / $1,107.77 / $3,658.62
| Professional | | $444.04 | $1,107.77 | $3,658.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.00 / $910.86 / $1,707.86
| Facility | | $294.00 | $910.86 | $1,707.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $797.00 / $1,001.95 / $1,647.14
| Professional | | $797.00 | $1,001.95 | $1,647.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.19 / $749.66 / $1,376.38
| Professional | | $645.19 | $749.66 | $1,376.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.07 / $1,851.70 / $1,969.39
| Facility | | $740.07 | $1,851.70 | $1,969.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.38 / $827.36 / $1,745.82
| Professional | | $493.38 | $827.36 | $1,745.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.80 / $455.43 / $1,216.00
| Professional | | $318.80 | $455.43 | $1,216.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $759.05 / $872.89 / $872.89
| Facility | | $759.05 | $872.89 | $872.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.19 / $759.05 / $912.31
| Professional | | $645.19 | $759.05 | $912.31 |