- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,189.46 / $1,958.05 / $3,668.09
| Facility | | $1,189.46 | $1,958.05 | $3,668.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $979.03 / $1,044.30 / $1,227.05
| Professional | | $979.03 | $1,044.30 | $1,227.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.60 / $943.78 / $3,681.14
| Facility | | $92.60 | $943.78 | $3,681.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,527.28 / $1,827.51 / $2,310.50
| Facility | | $1,527.28 | $1,827.51 | $2,310.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.40 / $1,915.63 / $5,090.93
| Facility | | $1,148.40 | $1,915.63 | $5,090.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $593.94 / $848.49 / $1,250.93
| Professional | | $593.94 | $848.49 | $1,250.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $825.52 / $1,148.40 / $1,226.88
| Professional | | $825.52 | $1,148.40 | $1,226.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,109.56 / $1,305.36 / $1,305.36
| Professional | | $1,109.56 | $1,305.36 | $1,305.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.39 / $783.22 / $1,546.73
| Professional | | $741.39 | $783.22 | $1,546.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $932.91 / $2,024.90 / $4,005.02
| Facility | | $932.91 | $2,024.90 | $4,005.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,500.02 / $1,500.02 / $1,875.02
| Professional | | $1,500.02 | $1,500.02 | $1,875.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.09 / $1,240.09 / $1,566.44
| Facility | | $1,240.09 | $1,240.09 | $1,566.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $548.26 / $783.22 / $1,476.37
| Professional | | $548.26 | $783.22 | $1,476.37 |