- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,818.38 / $7,244.36
| Facility | | $467.74 | $2,818.38 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $436.52 / $812.83
| Professional | | $288.40 | $436.52 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $446.68 / $758.58
| Professional | | $302.00 | $446.68 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $467.74 / $5,495.41
| Professional | | $346.74 | $467.74 | $5,495.41 |
- 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
- $309.03 / $478.63 / $831.76
| Professional | | $309.03 | $478.63 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $562.34 / $660.69
| Professional | | $436.52 | $562.34 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $602.56 / $1,047.13
| Professional | | $489.78 | $602.56 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $489.78 / $794.33
| Facility | | $316.23 | $489.78 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $416.87
| Professional | | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $398.11 / $6,918.31
| Facility | | $295.12 | $398.11 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $549.54 / $6,918.31
| Professional | | $398.11 | $549.54 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $7,079.46 / $13,803.84
| Facility | | $3,630.78 | $7,079.46 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $436.52 / $776.25
| Professional | | $263.03 | $436.52 | $776.25 |