- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $696.73 / $2,824.50 / $7,920.26
| Facility | | $696.73 | $2,824.50 | $7,920.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.30 / $456.01 / $1,228.97
| Professional | | $292.30 | $456.01 | $1,228.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $736.00 / $736.00 / $736.00
| Facility | | $736.00 | $736.00 | $736.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.17 / $779.39 / $1,348.61
| Professional | | $467.17 | $779.39 | $1,348.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.18 / $836.18 / $1,217.64
| Professional | | $660.18 | $836.18 | $1,217.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.06 / $731.23 / $1,104.18
| Facility | | $440.06 | $731.23 | $1,104.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $523.16 / $759.80 / $1,136.41
| Professional | | $523.16 | $759.80 | $1,136.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.21 / $868.11 / $1,013.71
| Facility | | $556.21 | $868.11 | $1,013.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.06 / $731.23 / $1,300.02
| Facility | | $440.06 | $731.23 | $1,300.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $586.95 / $855.36 / $1,316.54
| Professional | | $586.95 | $855.36 | $1,316.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,868.81 / $5,124.10 / $6,421.06
| Facility | | $3,868.81 | $5,124.10 | $6,421.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $600.24 / $929.06 / $1,400.82
| Professional | | $600.24 | $929.06 | $1,400.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $9,074.00 / $12,786.00
| Facility | | $1,981.00 | $9,074.00 | $12,786.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $659.77 / $973.94 / $1,503.29
| Professional | | $659.77 | $973.94 | $1,503.29 |