- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,311.31 / $5,128.61
| Facility | | $724.44 | $3,311.31 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $588.84 / $1,412.54
| Professional | | $467.74 | $588.84 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $6,025.60 / $45,708.82
| Facility | | $1,230.27 | $6,025.60 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $776.25 / $4,677.35
| Professional | | $467.74 | $776.25 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $1,047.13 / $1,412.54
| Professional | | $616.60 | $1,047.13 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $794.33 / $1,445.44
| Professional | | $524.81 | $794.33 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,071.52 / $7,079.46
| Facility | | $489.78 | $1,071.52 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $691.83 / $933.25
| Professional | | $549.54 | $691.83 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,918.31 / $15,488.17
| Facility | | $2,570.40 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $933.25 / $1,479.11
| Professional | | $501.19 | $933.25 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $6,025.60 / $45,708.82
| Facility | | $1,230.27 | $6,025.60 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $776.25 / $4,677.35
| Professional | | $467.74 | $776.25 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,165.95 / $14,125.38
| Facility | | $2,570.40 | $6,165.95 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $776.25 / $1,513.56
| Professional | | $524.81 | $776.25 | $1,513.56 |