- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,584.89 / $7,943.28
| Facility | | $371.54 | $1,584.89 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $426.58 / $891.25
| Professional | | $257.04 | $426.58 | $891.25 |
- 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
- $316.23 / $489.78 / $758.58
| Professional | | $316.23 | $489.78 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $812.83 / $1,071.52
| Professional | | $269.15 | $812.83 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $1,862.09
| Facility | | $512.86 | $512.86 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $524.81 / $831.76
| Professional | | $316.23 | $524.81 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $549.54 / $660.69
| Professional | | $416.87 | $549.54 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $741.31
| Professional | | $575.44 | $575.44 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $489.78 / $758.58
| Facility | | $281.84 | $489.78 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $933.25 / $933.25
| Professional | | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $489.78 / $4,073.80
| Facility | | $295.12 | $489.78 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $660.69 / $4,073.80
| Professional | | $446.68 | $660.69 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,202.26 / $2,511.89
| Facility | | $229.09 | $1,202.26 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $478.63 / $776.25
| Professional | | $288.40 | $478.63 | $776.25 |