- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $2,754.23 / $7,244.36
| Facility | | $812.83 | $2,754.23 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $616.60 / $954.99
| Professional | | $354.81 | $616.60 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $2,137.96 / $4,265.80
| Facility | | $1,288.25 | $2,137.96 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $758.58 / $933.25
| Professional | | $616.60 | $758.58 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $575.44 / $812.83
| Professional | | $389.05 | $575.44 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $891.25 / $4,786.30
| Facility | | $446.68 | $891.25 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $660.69 / $977.24
| Professional | | $389.05 | $660.69 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $3,630.78 / $5,248.07
| Facility | | $2,951.21 | $3,630.78 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $707.95 / $1,023.29
| Professional | | $457.09 | $707.95 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $602.56 / $3,890.45
| Professional | | $467.74 | $602.56 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $6,165.95 / $7,762.47
| Facility | | $3,467.37 | $6,165.95 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $549.54 / $851.14
| Professional | | $363.08 | $549.54 | $851.14 |