- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $1,096.48 / $2,344.23
| Facility | | $436.52 | $1,096.48 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $588.84 / $1,949.84
| Professional | | $436.52 | $588.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,570.88 / $7,079.46
| Facility | | $2,344.23 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $1,202.26 / $2,691.53
| Professional | | $616.60 | $1,202.26 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $1,949.84 / $3,162.28
| Facility | | $1,698.24 | $1,949.84 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $1,148.15 / $1,905.46
| Professional | | $588.84 | $1,148.15 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,258.93 / $3,715.35
| Facility | | $489.78 | $1,258.93 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $1,412.54 / $1,905.46
| Professional | | $977.24 | $1,412.54 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,412.54 / $5,128.61
| Facility | | $537.03 | $1,412.54 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $1,230.27 / $3,890.45
| Professional | | $602.56 | $1,230.27 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $1,513.56
| Professional | | $32.36 | $33.11 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,445.44 / $2,089.30
| Professional | | $891.25 | $1,445.44 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,890.45 / $3,890.45
| Facility | | $1,380.38 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $954.99 / $5,248.07
| Professional | | $537.03 | $954.99 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,238.72 / $2,818.38
| Professional | | $1,122.02 | $2,238.72 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,606.93
| Facility | | $2,884.03 | $3,801.89 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $912.01 / $2,238.72
| Professional | | $537.03 | $912.01 | $2,238.72 |