- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $588.84 / $2,238.72
| Facility | | $354.81 | $588.84 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $524.81 / $1,862.09
| Professional | | $302.00 | $524.81 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $707.95 / $1,548.82
| Professional | | $426.58 | $707.95 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,621.81 / $2,570.40
| Facility | | $1,380.38 | $1,621.81 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $1,288.25 / $2,398.83
| Professional | | $524.81 | $1,288.25 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $645.65 / $3,548.13
| Facility | | $323.59 | $645.65 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $933.25 / $1,412.54
| Professional | | $588.84 | $933.25 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $660.69 / $4,786.30
| Facility | | $323.59 | $660.69 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $954.99 / $3,801.89
| Professional | | $416.87 | $954.99 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $416.87
| Professional | | $32.36 | $33.11 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $1,071.52 / $1,819.70
| Professional | | $602.56 | $1,071.52 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,754.23 / $3,981.07
| Facility | | $1,445.44 | $2,754.23 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $2,454.71 / $3,715.35
| Professional | | $588.84 | $2,454.71 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $1,995.26 / $3,311.31
| Professional | | $562.34 | $1,995.26 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,456.54
| Facility | | $2,884.03 | $3,801.89 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $660.69 / $1,778.28
| Professional | | $346.74 | $660.69 | $1,778.28 |