- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,202.26 / $7,943.28
| Facility | | $891.25 | $1,202.26 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $489.78 / $1,148.15
| Professional | | $398.11 | $489.78 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $741.31
| Facility | | $741.31 | $741.31 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $812.83 / $1,258.93
| Professional | | $467.74 | $812.83 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $912.01 / $1,122.02
| Professional | | $691.83 | $912.01 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $676.08 / $1,096.48
| Facility | | $436.52 | $676.08 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $794.33 / $1,174.90
| Professional | | $676.08 | $794.33 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $851.14 / $933.25
| Facility | | $645.65 | $851.14 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $676.08 / $977.24
| Facility | | $436.52 | $676.08 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $831.76 / $1,230.27
| Professional | | $79.43 | $831.76 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,232.93 / $12,302.69
| Facility | | $7,762.47 | $10,232.93 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $933.25 / $1,288.25
| Professional | | $758.58 | $933.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,754.40 / $14,125.38
| Facility | | $1,698.24 | $5,754.40 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $851.14 / $1,202.26
| Professional | | $575.44 | $851.14 | $1,202.26 |