- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $4,365.16 / $8,317.64
| Facility | | $407.38 | $4,365.16 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $380.19 / $707.95
| Professional | | $234.42 | $380.19 | $707.95 |
- 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
- $245.47 / $363.08 / $630.96
| Professional | | $245.47 | $363.08 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $389.05 / $4,365.16
| Professional | | $269.15 | $389.05 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $398.11 / $724.44
| Professional | | $257.04 | $398.11 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $489.78 / $575.44
| Professional | | $380.19 | $489.78 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $501.19 / $912.01
| Professional | | $398.11 | $501.19 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $407.38 / $676.08
| Facility | | $257.04 | $407.38 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $389.05
| Professional | | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $331.13 / $6,918.31
| Facility | | $239.88 | $331.13 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $478.63 / $6,918.31
| Professional | | $346.74 | $478.63 | $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
- $218.78 / $363.08 / $660.69
| Professional | | $218.78 | $363.08 | $660.69 |