- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.32 / $5,463.36 / $12,765.09
| Facility | | $350.32 | $5,463.36 | $12,765.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.32 / $350.32 / $1,289.52
| Professional | | $225.32 | $350.32 | $1,289.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.09 / $358.18 / $865.82
| Professional | | $179.09 | $358.18 | $865.82 |
- 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
- $241.28 / $457.75 / $717.29
| Professional | | $241.28 | $457.75 | $717.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $359.54 / $359.54 / $359.54
| Facility | | $359.54 | $359.54 | $359.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.53 / $736.07 / $1,090.74
| Professional | | $457.53 | $736.07 | $1,090.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.37 / $437.90 / $1,149.28
| Facility | | $267.37 | $437.90 | $1,149.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.88 / $792.42 / $1,832.96
| Professional | | $478.88 | $792.42 | $1,832.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.66 / $621.19 / $1,006.43
| Facility | | $404.66 | $621.19 | $1,006.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.89 / $706.62 / $1,006.43
| Professional | | $496.89 | $706.62 | $1,006.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.49 / $452.45 / $756.63
| Professional | | $259.49 | $452.45 | $756.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,247.76 / $5,356.00 / $7,934.00
| Facility | | $1,247.76 | $5,356.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.88 / $792.00 / $1,031.44
| Professional | | $478.88 | $792.00 | $1,031.44 |