- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.72 / $747.37 / $6,953.60
| Facility | | $350.72 | $747.37 | $6,953.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.37 / $555.91 / $1,048.84
| Professional | | $505.37 | $555.91 | $1,048.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.99 / $1,461.99 / $1,483.32
| Facility | | $1,461.99 | $1,461.99 | $1,483.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $621.89 / $983.99 / $1,464.42
| Professional | | $621.89 | $983.99 | $1,464.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,438.74
| Facility | | $530.04 | $530.04 | $1,438.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $597.90 / $770.60 / $1,361.49
| Professional | | $597.90 | $770.60 | $1,361.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.22 / $674.00 / $1,139.91
| Facility | | $554.22 | $674.00 | $1,139.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $681.00 / $776.00
| Professional | | $507.00 | $681.00 | $776.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $933.77 / $1,462.40
| Professional | | $3.00 | $933.77 | $1,462.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $469.39 / $650.41 / $1,344.46
| Professional | | $469.39 | $650.41 | $1,344.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,240.19 / $4,754.80 / $16,394.00
| Facility | | $2,240.19 | $4,754.80 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,336.08 / $4,336.08 / $5,163.08
| Professional | | $4,336.08 | $4,336.08 | $5,163.08 |