- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $2,238.72 / $3,801.89
| Facility | | $354.81 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $407.38 / $977.24
| Professional | | $331.13 | $407.38 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,071.52 / $19,498.45
| Facility | | $467.74 | $1,071.52 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $537.03 / $1,348.96
| Professional | | $323.59 | $537.03 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $1,023.29
| Facility | | $446.68 | $446.68 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $588.84 / $1,096.48
| Professional | | $380.19 | $588.84 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $812.83 / $7,079.46
| Facility | | $371.54 | $812.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $616.60 / $812.83
| Professional | | $501.19 | $616.60 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $691.83 / $1,122.02
| Professional | | $436.52 | $691.83 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,071.52 / $19,498.45
| Facility | | $467.74 | $1,071.52 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $537.03 / $1,348.96
| Professional | | $323.59 | $537.03 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $562.34 / $1,122.02
| Professional | | $363.08 | $562.34 | $1,122.02 |