- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $1,513.56 / $7,079.46
| Facility | | $316.23 | $1,513.56 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $295.12 / $645.65
| Professional | | $204.17 | $295.12 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $346.74 / $512.86
| Professional | | $234.42 | $346.74 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $2,570.40 / $3,548.13
| Professional | | $218.78 | $2,570.40 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $1,659.59
| Facility | | $380.19 | $380.19 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $338.84 / $562.34
| Professional | | $218.78 | $338.84 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $380.19 / $446.68
| Professional | | $288.40 | $380.19 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $489.78
| Professional | | $416.87 | $416.87 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $331.13 / $501.19
| Facility | | $218.78 | $331.13 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,621.81 / $1,621.81
| Professional | | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $323.59 / $3,311.31
| Facility | | $213.80 | $323.59 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $426.58 / $3,311.31
| Professional | | $281.84 | $426.58 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,290.87 / $4,466.84
| Facility | | $1,122.02 | $2,290.87 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $323.59 / $524.81
| Professional | | $208.93 | $323.59 | $524.81 |