- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.73 / $1,603.06 / $2,171.32
| Facility | | $498.73 | $1,603.06 | $2,171.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $468.45 / $498.73 / $527.23
| Professional | | $468.45 | $498.73 | $527.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,239.70 / $3,384.23 / $3,384.23
| Facility | | $1,239.70 | $3,384.23 | $3,384.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.99 / $427.48 / $1,246.82
| Professional | | $284.99 | $427.48 | $1,246.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $555.73 / $1,620.89
| Facility | | $467.74 | $555.73 | $1,620.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $818.98 / $868.13 / $1,085.16
| Professional | | $818.98 | $868.13 | $1,085.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,028.24 / $1,028.24 / $1,209.70
| Professional | | $1,028.24 | $1,028.24 | $1,209.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $712.47 / $712.47 / $1,660.06
| Professional | | $712.47 | $712.47 | $1,660.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,239.70 / $3,384.23 / $3,384.23
| Facility | | $1,239.70 | $3,384.23 | $3,384.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.99 / $427.48 / $1,246.82
| Professional | | $284.99 | $427.48 | $1,246.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.22 / $712.47 / $854.96
| Facility | | $641.22 | $712.47 | $854.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.24 / $427.48 / $1,068.71
| Professional | | $299.24 | $427.48 | $1,068.71 |