- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,621.81 / $5,495.41
| Facility | | $1,318.26 | $1,621.81 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $501.19 / $933.25
| Professional | | $331.13 | $501.19 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,388.44 / $7,413.10
| Facility | | $1,023.29 | $3,388.44 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $776.25 / $977.24
| Professional | | $616.60 | $776.25 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $1,445.44
| Facility | | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $562.34 / $812.83
| Professional | | $416.87 | $562.34 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $707.95 / $1,202.26
| Facility | | $426.58 | $707.95 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $870.96 / $1,096.48
| Professional | | $562.34 | $870.96 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,456.54 / $8,912.51
| Facility | | $4,570.88 | $6,456.54 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $758.58 / $1,047.13
| Professional | | $537.03 | $758.58 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $645.65 / $4,365.16
| Professional | | $436.52 | $645.65 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,467.37 / $7,762.47
| Facility | | $676.08 | $3,467.37 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $616.60 / $891.25
| Professional | | $398.11 | $616.60 | $891.25 |