- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,949.84 / $10,471.29
| Facility | | $691.83 | $1,949.84 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $562.34 / $1,318.26
| Professional | | $478.63 | $562.34 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $2,344.23
| Facility | | $2,290.87 | $2,290.87 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $1,047.13 / $1,412.54
| Professional | | $575.44 | $1,047.13 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $724.44 / $1,288.25
| Professional | | $537.03 | $724.44 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $1,258.93
| Professional | | $851.14 | $851.14 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $676.08 / $1,047.13
| Facility | | $524.81 | $676.08 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $954.99 / $1,148.15
| Professional | | $794.33 | $954.99 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $14,791.08 / $22,908.68
| Facility | | $3,981.07 | $14,791.08 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $575.44 / $1,122.02
| Professional | | $446.68 | $575.44 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $45,708.82
| Facility | | $8,912.51 | $8,912.51 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,981.07 / $3,981.07 / $4,786.30
| Professional | | $3,981.07 | $3,981.07 | $4,786.30 |