- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.38 / $6,732.07 / $19,276.96
| Facility | | $376.38 | $6,732.07 | $19,276.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.75 / $376.38 / $1,303.61
| Professional | | $246.75 | $376.38 | $1,303.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $745.18 / $745.18 / $745.18
| Professional | | $745.18 | $745.18 | $745.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,712.35 / $6,198.03 / $11,988.99
| Facility | | $4,712.35 | $6,198.03 | $11,988.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.92 / $495.67 / $769.78
| Professional | | $263.92 | $495.67 | $769.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.28 / $789.93 / $1,166.70
| Professional | | $432.28 | $789.93 | $1,166.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.13 / $490.51 / $1,257.52
| Facility | | $292.13 | $490.51 | $1,257.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $513.60 / $849.42 / $2,004.88
| Professional | | $513.60 | $849.42 | $2,004.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.88 / $874.80 / $2,842.49
| Facility | | $585.88 | $874.80 | $2,842.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $539.54 / $758.33 / $1,082.08
| Professional | | $539.54 | $758.33 | $1,082.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.42 / $494.17 / $809.98
| Professional | | $283.42 | $494.17 | $809.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $513.60 / $840.83 / $1,106.22
| Professional | | $513.60 | $840.83 | $1,106.22 |