- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.12 / $2,537.39 / $7,945.98
| Facility | | $451.12 | $2,537.39 | $7,945.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.92 / $489.54 / $815.32
| Professional | | $341.92 | $489.54 | $815.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.32 / $191.32 / $191.32
| Professional | | $191.32 | $191.32 | $191.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.07 / $710.29 / $1,234.86
| Professional | | $390.07 | $710.29 | $1,234.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.06 / $621.30 / $1,130.75
| Professional | | $436.06 | $621.30 | $1,130.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.61 / $613.29 / $893.89
| Facility | | $360.61 | $613.29 | $893.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.00 / $662.00 / $683.00
| Professional | | $507.00 | $662.00 | $683.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.62 / $652.02 / $861.64
| Professional | | $442.62 | $652.02 | $861.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.41 / $602.44 / $1,272.36
| Professional | | $439.41 | $602.44 | $1,272.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,693.36 / $1,871.79 / $16,394.00
| Facility | | $1,693.36 | $1,871.79 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,686.16 / $3,836.16 / $4,473.30
| Professional | | $2,686.16 | $3,836.16 | $4,473.30 |