- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $309.03 / $660.69
| Professional | | $144.54 | $309.03 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $398.11 / $524.81
| Professional | | $257.04 | $398.11 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $302.00 / $549.54
| Professional | | $158.49 | $302.00 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $478.63
| Professional | | $457.09 | $457.09 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $426.58 / $707.95
| Professional | | $208.93 | $426.58 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $281.84 / $436.52
| Professional | | $147.91 | $281.84 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,344.23 / $8,317.64
| Facility | | $616.60 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $331.13 / $707.95
| Professional | | $147.91 | $331.13 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $549.54 / $912.01
| Professional | | $524.81 | $549.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $275.42 / $912.01
| Facility | | $128.82 | $275.42 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $173.78 / $416.87
| Professional | | $112.20 | $173.78 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $676.08 / $4,265.80
| Facility | | $144.54 | $676.08 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $295.12 / $549.54
| Professional | | $144.54 | $295.12 | $549.54 |