- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,466.84 / $5,495.41
| Facility | | $1,412.54 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $562.34 / $1,122.02
| Professional | | $346.74 | $562.34 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $3,630.78 / $8,511.38
| Facility | | $1,479.11 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $912.01 / $1,202.26
| Professional | | $691.83 | $912.01 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $1,905.46 / $1,905.46
| Facility | | $1,905.46 | $1,905.46 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $676.08 / $1,047.13
| Professional | | $398.11 | $676.08 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $676.08 / $1,445.44
| Facility | | $416.87 | $676.08 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $977.24 / $1,318.26
| Professional | | $660.69 | $977.24 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $7,244.36 / $10,232.93
| Facility | | $5,495.41 | $7,244.36 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $851.14 / $1,318.26
| Professional | | $588.84 | $851.14 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $660.69 / $5,011.87
| Professional | | $549.54 | $660.69 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $5,495.41 / $12,302.69
| Facility | | $1,348.96 | $5,495.41 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $630.96 / $1,047.13
| Professional | | $380.19 | $630.96 | $1,047.13 |