- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $3,467.37 / $7,244.36
| Facility | | $512.86 | $3,467.37 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $457.09 / $933.25
| Professional | | $302.00 | $457.09 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $478.63 / $812.83
| Professional | | $323.59 | $478.63 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $512.86 / $5,495.41
| Professional | | $354.81 | $512.86 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $575.44
| Facility | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $512.86 / $912.01
| Professional | | $338.84 | $512.86 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $616.60 / $741.31
| Professional | | $489.78 | $616.60 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $645.65 / $1,148.15
| Professional | | $524.81 | $645.65 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $512.86 / $851.14
| Facility | | $338.84 | $512.86 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $426.58 / $426.58
| Professional | | $426.58 | $426.58 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $426.58 / $6,918.31
| Facility | | $316.23 | $426.58 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $602.56 / $6,918.31
| Professional | | $407.38 | $602.56 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $7,079.46 / $14,125.38
| Facility | | $3,715.35 | $7,079.46 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $467.74 / $831.76
| Professional | | $281.84 | $467.74 | $831.76 |