- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $3,630.78 / $8,317.64
| Facility | | $398.11 | $3,630.78 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $389.05 / $851.14
| Professional | | $331.13 | $389.05 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $537.03 / $933.25
| Professional | | $371.54 | $537.03 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $588.84 / $3,548.13
| Professional | | $380.19 | $588.84 | $3,548.13 |
- 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
- $363.08 / $512.86 / $794.33
| Professional | | $363.08 | $512.86 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $446.68 / $537.03
| Professional | | $354.81 | $446.68 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $758.58 / $851.14
| Professional | | $602.56 | $758.58 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $467.74 / $758.58
| Facility | | $346.74 | $467.74 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $251.19
| Professional | | $251.19 | $251.19 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $501.19 / $6,918.31
| Facility | | $354.81 | $501.19 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $501.19 / $6,918.31
| Professional | | $354.81 | $501.19 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $7,079.46 / $13,803.84
| Facility | | $3,630.78 | $7,079.46 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $457.09 / $776.25
| Professional | | $275.42 | $457.09 | $776.25 |