- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,311.31 / $5,128.61
| Facility | | $1,778.28 | $3,311.31 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $489.78 / $1,230.27
| Professional | | $416.87 | $489.78 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,659.59 / $45,708.82
| Facility | | $630.96 | $1,659.59 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $691.83 / $3,467.37
| Professional | | $426.58 | $691.83 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $724.44 / $1,348.96
| Professional | | $457.09 | $724.44 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,023.29 / $7,079.46
| Facility | | $467.74 | $1,023.29 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $660.69 / $912.01
| Professional | | $524.81 | $660.69 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $891.25 / $1,318.26
| Professional | | $478.63 | $891.25 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $2,951.21 / $7,413.10
| Facility | | $2,951.21 | $2,951.21 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,659.59 / $45,708.82
| Facility | | $741.31 | $1,659.59 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $691.83 / $3,467.37
| Professional | | $426.58 | $691.83 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $707.95 / $1,380.38
| Professional | | $457.09 | $707.95 | $1,380.38 |