- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $2,187.76 / $3,801.89
| Facility | | $363.08 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $407.38 / $954.99
| Professional | | $331.13 | $407.38 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,071.52 / $19,498.45
| Facility | | $467.74 | $1,071.52 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $549.54 / $1,380.38
| Professional | | $323.59 | $549.54 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $1,047.13
| Facility | | $457.09 | $457.09 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $588.84 / $1,096.48
| Professional | | $354.81 | $588.84 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $831.76 / $7,079.46
| Facility | | $371.54 | $831.76 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $630.96 / $812.83
| Professional | | $512.86 | $630.96 | $812.83 |
- 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
- $446.68 / $707.95 / $1,148.15
| Professional | | $446.68 | $707.95 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,071.52 / $19,498.45
| Facility | | $467.74 | $1,071.52 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $549.54 / $1,380.38
| Professional | | $323.59 | $549.54 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $562.34 / $1,148.15
| Professional | | $363.08 | $562.34 | $1,148.15 |