- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $1,949.84 / $7,079.46
| Facility | | $194.98 | $1,949.84 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $223.87 / $380.19
| Professional | | $144.54 | $223.87 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,570.40 / $2,951.21
| Facility | | $2,137.96 | $2,570.40 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $269.15 / $416.87
| Professional | | $173.78 | $269.15 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $1,513.56 / $2,511.89
| Professional | | $181.97 | $1,513.56 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $281.84 / $1,318.26
| Facility | | $281.84 | $281.84 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $245.47 / $426.58
| Professional | | $165.96 | $245.47 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $295.12 / $354.81
| Professional | | $229.09 | $295.12 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $309.03
| Professional | | $275.42 | $275.42 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $234.42 / $371.54
| Facility | | $154.88 | $234.42 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,047.13 / $1,047.13
| Professional | | $1,047.13 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $223.87 / $3,311.31
| Facility | | $131.83 | $223.87 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $331.13 / $3,311.31
| Professional | | $213.80 | $331.13 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,137.96 / $3,981.07
| Facility | | $1,096.48 | $2,137.96 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $223.87 / $407.38
| Professional | | $138.04 | $223.87 | $407.38 |