- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,818.38 / $5,128.61
| Facility | | $467.74 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $467.74 / $954.99
| Professional | | $316.23 | $467.74 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $4,897.79 / $28,840.32
| Facility | | $776.25 | $4,897.79 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $616.60 / $1,445.44
| Professional | | $346.74 | $616.60 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $912.01
| Facility | | $398.11 | $398.11 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $645.65 / $1,174.90
| Professional | | $363.08 | $645.65 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $691.83 / $7,079.46
| Facility | | $323.59 | $691.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $676.08 / $933.25
| Professional | | $549.54 | $676.08 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $660.69 / $1,230.27
| Professional | | $380.19 | $660.69 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $4,897.79 / $28,840.32
| Facility | | $776.25 | $4,897.79 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $616.60 / $1,445.44
| Professional | | $346.74 | $616.60 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $630.96 / $1,258.93
| Professional | | $380.19 | $630.96 | $1,258.93 |