- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,090.30 / $5,248.07
| Facility | | $1,071.52 | $3,090.30 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $616.60 / $851.14
| Professional | | $489.78 | $616.60 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $3,801.89 / $3,890.45
| Facility | | $1,905.46 | $3,801.89 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,479.11 / $2,398.83
| Professional | | $1,258.93 | $1,479.11 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $1,148.15 / $2,089.30
| Facility | | $97.72 | $1,148.15 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $575.44 / $1,258.93
| Professional | | $446.68 | $575.44 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $977.24 / $2,454.71
| Facility | | $512.86 | $977.24 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $831.76 / $1,023.29
| Professional | | $758.58 | $831.76 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $831.76 / $1,318.26
| Professional | | $691.83 | $831.76 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $3,630.78 / $3,630.78
| Facility | | $3,630.78 | $3,630.78 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,754.40 / $5,754.40
| Professional | | $3,801.89 | $5,754.40 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $912.01 / $1,737.80
| Facility | | $549.54 | $912.01 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $831.76 / $831.76
| Professional | | $758.58 | $831.76 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $316.23 / $1,445.44
| Professional | | $316.23 | $316.23 | $1,445.44 |