- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.16 / $739.12 / $2,031.80
| Facility | | $212.16 | $739.12 | $2,031.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.16 / $234.79 / $240.45
| Professional | | $154.16 | $234.79 | $240.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $614.00 / $1,417.23
| Facility | | $244.00 | $614.00 | $1,417.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.98 / $254.07 / $363.95
| Professional | | $220.98 | $254.07 | $363.95 |
- 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 / $459.77
| Professional | | $128.71 | $183.87 | $459.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.63 / $474.38 / $946.93
| Facility | | $186.63 | $474.38 | $946.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.30 / $282.88 / $381.89
| Professional | | $226.30 | $282.88 | $381.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.59 / $325.31 / $540.29
| Professional | | $254.59 | $325.31 | $540.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $492.21 / $1,343.68 / $1,343.68
| Facility | | $492.21 | $1,343.68 | $1,343.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,408.74 / $1,408.74 / $2,121.60
| Professional | | $1,408.74 | $1,408.74 | $2,121.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.30 / $339.46 / $750.56
| Facility | | $226.30 | $339.46 | $750.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.88 / $311.17 / $424.32
| Professional | | $282.88 | $311.17 | $424.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.30 / $254.59 / $384.71
| Professional | | $226.30 | $254.59 | $384.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.46 / $339.46 / $339.46
| Facility | | $339.46 | $339.46 | $339.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.81 / $118.81 / $567.74
| Professional | | $118.81 | $118.81 | $567.74 |