- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,466.84 / $5,495.41
| Facility | | $2,884.03 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $616.60 / $954.99
| Professional | | $398.11 | $616.60 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $2,238.72 / $4,897.79
| Facility | | $1,230.27 | $2,238.72 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $912.01 / $954.99
| Professional | | $776.25 | $912.01 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $1,174.90
| Facility | | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $616.60 / $812.83
| Professional | | $467.74 | $616.60 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $741.31 / $1,174.90
| Facility | | $457.09 | $741.31 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $851.14 / $1,148.15
| Professional | | $758.58 | $851.14 | $1,148.15 |
- 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
- $3,311.31 / $4,677.35 / $6,025.60
| Facility | | $3,311.31 | $4,677.35 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $912.01 / $1,023.29
| Professional | | $645.65 | $912.01 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $549.54 / $3,715.35
| Professional | | $416.87 | $549.54 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,467.37 / $7,762.47
| Facility | | $676.08 | $3,467.37 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $676.08 / $954.99
| Professional | | $436.52 | $676.08 | $954.99 |