- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $3,235.94 / $8,317.64
| Facility | | $537.03 | $3,235.94 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $501.19 / $933.25
| Professional | | $416.87 | $501.19 | $933.25 |
- 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
- $446.68 / $660.69 / $1,148.15
| Professional | | $446.68 | $660.69 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $676.08 / $2,511.89
| Professional | | $467.74 | $676.08 | $2,511.89 |
- 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
- $436.52 / $562.34 / $1,047.13
| Professional | | $436.52 | $562.34 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $676.08 / $812.83
| Professional | | $537.03 | $676.08 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $707.95 / $1,148.15
| Professional | | $575.44 | $707.95 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $575.44 / $912.01
| Facility | | $426.58 | $575.44 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $478.63 / $478.63
| Professional | | $478.63 | $478.63 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $537.03 / $2,630.27
| Facility | | $389.05 | $537.03 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $602.56 / $2,630.27
| Professional | | $436.52 | $602.56 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,137.96 / $3,981.07
| Facility | | $1,071.52 | $2,137.96 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $524.81 / $912.01
| Professional | | $338.84 | $524.81 | $912.01 |