- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,047.13 / $8,317.64
| Facility | | $380.19 | $1,047.13 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $575.44 / $1,148.15
| Professional | | $398.11 | $575.44 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $371.54 / $1,174.90
| Professional | | $213.80 | $371.54 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $691.83 / $1,479.11
| Professional | | $467.74 | $691.83 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $660.69 / $1,258.93
| Professional | | $446.68 | $660.69 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $1,380.38
| Professional | | $707.95 | $707.95 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $616.60 / $1,023.29
| Facility | | $436.52 | $616.60 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,096.48 / $1,288.25
| Professional | | $870.96 | $1,096.48 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,918.31 / $10,471.29
| Facility | | $2,187.76 | $6,918.31 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $575.44 / $1,047.13
| Professional | | $389.05 | $575.44 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $45,708.82
| Facility | | $8,912.51 | $8,912.51 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,265.80 / $4,265.80 / $4,897.79
| Professional | | $4,265.80 | $4,265.80 | $4,897.79 |