- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $5,128.61 / $6,165.95
| Facility | | $562.34 | $5,128.61 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $588.84 / $1,348.96
| Professional | | $346.74 | $588.84 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,548.13 / $8,511.38
| Facility | | $1,778.28 | $3,548.13 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $870.96 / $1,122.02
| Professional | | $676.08 | $870.96 | $1,122.02 |
- 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
- $436.52 / $645.65 / $977.24
| Professional | | $436.52 | $645.65 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $794.33 / $4,786.30
| Facility | | $436.52 | $794.33 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $912.01 / $1,174.90
| Professional | | $616.60 | $912.01 | $1,174.90 |
- 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
- $575.44 / $794.33 / $1,202.26
| Professional | | $575.44 | $794.33 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $707.95 / $3,162.28
| Professional | | $512.86 | $707.95 | $3,162.28 |
- 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
- $416.87 / $660.69 / $1,047.13
| Professional | | $416.87 | $660.69 | $1,047.13 |