- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,235.94 / $7,244.36
| Facility | | $562.34 | $3,235.94 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $549.54 / $1,148.15
| Professional | | $426.58 | $549.54 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $7,413.10 / $9,332.54
| Facility | | $6,606.93 | $7,413.10 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $616.60 / $1,047.13
| Professional | | $426.58 | $616.60 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $676.08 / $8,317.64
| Professional | | $436.52 | $676.08 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $575.44
| Facility | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $645.65 / $1,122.02
| Professional | | $446.68 | $645.65 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $724.44 / $851.14
| Professional | | $562.34 | $724.44 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $794.33 / $1,258.93
| Professional | | $645.65 | $794.33 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $676.08 / $1,096.48
| Facility | | $446.68 | $676.08 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $457.09
| Professional | | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $602.56 / $6,918.31
| Facility | | $426.58 | $602.56 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $741.31 / $6,918.31
| Professional | | $501.19 | $741.31 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $7,244.36 / $14,125.38
| Facility | | $3,801.89 | $7,244.36 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $602.56 / $1,047.13
| Professional | | $371.54 | $602.56 | $1,047.13 |