- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $4,365.16 / $8,317.64
| Facility | | $338.84 | $4,365.16 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $309.03 / $501.19
| Professional | | $218.78 | $309.03 | $501.19 |
- 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
- $257.04 / $398.11 / $616.60
| Professional | | $257.04 | $398.11 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $776.25 / $1,047.13
| Professional | | $251.19 | $776.25 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $436.52 / $1,862.09
| Facility | | $436.52 | $436.52 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $354.81 / $588.84
| Professional | | $239.88 | $354.81 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $478.63 / $575.44
| Professional | | $363.08 | $478.63 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $537.03
| Professional | | $380.19 | $380.19 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $331.13 / $537.03
| Facility | | $218.78 | $331.13 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $616.60
| Professional | | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $323.59 / $4,073.80
| Facility | | $208.93 | $323.59 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $446.68 / $4,073.80
| Professional | | $309.03 | $446.68 | $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
- $213.80 / $331.13 / $575.44
| Professional | | $213.80 | $331.13 | $575.44 |