- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.97 / $4,241.22 / $12,765.09
| Facility | | $360.97 | $4,241.22 | $12,765.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.59 / $360.97 / $680.12
| Professional | | $104.59 | $360.97 | $680.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.10 / $141.10 / $141.10
| Professional | | $141.10 | $141.10 | $141.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,609.82 / $6,063.17 / $11,728.12
| Facility | | $4,609.82 | $6,063.17 | $11,728.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.61 / $285.49 / $714.21
| Professional | | $125.61 | $285.49 | $714.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,062.42 / $1,062.42 / $1,062.42
| Facility | | $1,062.42 | $1,062.42 | $1,062.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.04 / $703.57 / $1,240.52
| Professional | | $244.04 | $703.57 | $1,240.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.78 / $438.89 / $2,614.33
| Facility | | $140.78 | $438.89 | $2,614.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.99 / $932.34 / $1,414.80
| Professional | | $511.99 | $932.34 | $1,414.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.19 / $953.00 / $1,373.28
| Facility | | $280.19 | $953.00 | $1,373.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.14 / $806.40 / $1,235.75
| Professional | | $250.14 | $806.40 | $1,235.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.99 / $913.25 / $1,201.55
| Professional | | $511.99 | $913.25 | $1,201.55 |