- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.47 / $8,042.03 / $19,276.96
| Facility | | $209.47 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.69 / $203.21 / $799.50
| Professional | | $140.69 | $203.21 | $799.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,303.68 / $6,975.78 / $13,493.42
| Facility | | $5,303.68 | $6,975.78 | $13,493.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.13 / $299.37 / $437.58
| Professional | | $163.13 | $299.37 | $437.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.89 / $449.05 / $611.79
| Professional | | $258.89 | $449.05 | $611.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.80 / $286.29 / $1,182.90
| Facility | | $179.80 | $286.29 | $1,182.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.55 / $420.55 / $1,246.64
| Professional | | $259.55 | $420.55 | $1,246.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.23 / $492.86 / $2,842.49
| Facility | | $362.23 | $492.86 | $2,842.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.93 / $416.44 / $586.49
| Professional | | $315.93 | $416.44 | $586.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.73 / $308.14 / $469.33
| Professional | | $176.73 | $308.14 | $469.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.18 / $414.64 / $547.97
| Professional | | $246.18 | $414.64 | $547.97 |