- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.33 / $4,778.89 / $13,841.56
| Facility | | $379.33 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.62 / $379.33 / $912.00
| Professional | | $250.62 | $379.33 | $912.00 |
- 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
- $269.12 / $505.42 / $778.57
| Professional | | $269.12 | $505.42 | $778.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,257.44 / $1,257.44 / $1,257.44
| Facility | | $1,257.44 | $1,257.44 | $1,257.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.05 / $798.96 / $1,193.00
| Professional | | $459.05 | $798.96 | $1,193.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $299.69 / $499.77 / $1,415.25
| Facility | | $299.69 | $499.77 | $1,415.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.40 / $840.82 / $2,044.96
| Professional | | $508.40 | $840.82 | $2,044.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.08 / $894.47 / $1,522.00
| Facility | | $604.08 | $894.47 | $1,522.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $535.99 / $766.98 / $1,092.91
| Professional | | $535.99 | $766.98 | $1,092.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.82 / $507.06 / $825.55
| Professional | | $290.82 | $507.06 | $825.55 |
- 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
- $508.40 / $827.65 / $1,095.02
| Professional | | $508.40 | $827.65 | $1,095.02 |