- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,258.93 / $8,317.64
| Facility | | $588.84 | $1,258.93 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $741.31 / $1,819.70
| Professional | | $549.54 | $741.31 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $13,182.57
| Facility | | $5,011.87 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $1,230.27 / $3,162.28
| Professional | | $588.84 | $1,230.27 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,862.09 / $3,090.30
| Facility | | $1,584.89 | $1,862.09 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $2,570.40 / $3,090.30
| Professional | | $776.25 | $2,570.40 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,230.27 / $6,456.54
| Facility | | $602.56 | $1,230.27 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,445.44 / $1,862.09
| Professional | | $1,096.48 | $1,445.44 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,258.93 / $11,220.18
| Facility | | $616.60 | $1,258.93 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $1,071.52 / $6,309.57
| Professional | | $602.56 | $1,071.52 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $891.25 / $1,348.96 / $2,041.74
| Professional | | $891.25 | $1,348.96 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $6,025.60 / $8,912.51
| Facility | | $3,235.94 | $6,025.60 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,884.03 / $6,309.57
| Professional | | $1,071.52 | $2,884.03 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,311.31 / $3,801.89
| Professional | | $1,698.24 | $3,311.31 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $12,589.25
| Facility | | $6,606.93 | $10,232.93 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $891.25 / $2,454.71
| Professional | | $588.84 | $891.25 | $2,454.71 |