- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,778.28 / $8,511.38
| Facility | | $371.54 | $1,778.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $354.81 / $660.69
| Professional | | $302.00 | $354.81 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $10,715.19 / $11,220.18
| Facility | | $5,011.87 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $302.00 / $426.58
| Professional | | $245.47 | $302.00 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $446.68 / $575.44
| Facility | | $331.13 | $446.68 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $436.52 / $549.54
| Professional | | $331.13 | $436.52 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $602.56 / $602.56
| Facility | | $34.67 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $524.81 / $1,737.80
| Professional | | $316.23 | $524.81 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $204.17
| Professional | | $32.36 | $33.11 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $602.56 / $3,162.28
| Facility | | $50.12 | $602.56 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $371.54 / $645.65
| Professional | | $275.42 | $371.54 | $645.65 |