- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $3,388.44 / $5,370.32
| Facility | | $512.86 | $3,388.44 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $616.60 / $1,621.81
| Professional | | $446.68 | $616.60 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $7,244.36 / $33,884.42
| Facility | | $1,122.02 | $7,244.36 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $794.33 / $1,819.70
| Professional | | $467.74 | $794.33 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $1,258.93
| Facility | | $549.54 | $549.54 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $1,023.29 / $1,995.26
| Professional | | $562.34 | $1,023.29 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $912.01 / $7,079.46
| Facility | | $426.58 | $912.01 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $933.25 / $1,380.38
| Professional | | $741.31 | $933.25 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,165.95 / $13,182.57
| Facility | | $2,511.89 | $6,165.95 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $870.96 / $1,621.81
| Professional | | $512.86 | $870.96 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $7,585.78 / $33,884.42
| Facility | | $1,122.02 | $7,585.78 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $794.33 / $1,819.70
| Professional | | $467.74 | $794.33 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,309.57 / $13,803.84
| Facility | | $2,511.89 | $6,309.57 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $870.96 / $1,698.24
| Professional | | $575.44 | $870.96 | $1,698.24 |