- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $2,884.03 / $7,244.36
| Facility | | $257.04 | $2,884.03 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $239.88 / $371.54
| Professional | | $151.36 | $239.88 | $371.54 |
- 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
- $186.21 / $288.40 / $436.52
| Professional | | $186.21 | $288.40 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $1,513.56 / $2,511.89
| Professional | | $194.98 | $1,513.56 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $1,318.26
| Facility | | $309.03 | $309.03 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $269.15 / $457.09
| Professional | | $186.21 | $269.15 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $316.23 / $380.19
| Professional | | $239.88 | $316.23 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $371.54
| Professional | | $323.59 | $323.59 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $257.04 / $398.11
| Facility | | $169.82 | $257.04 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $537.03 / $537.03
| Professional | | $537.03 | $537.03 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $245.47 / $3,311.31
| Facility | | $162.18 | $245.47 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $354.81 / $3,311.31
| Professional | | $234.42 | $354.81 | $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
- $154.88 / $245.47 / $426.58
| Professional | | $154.88 | $245.47 | $426.58 |