- 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 / $323.59 / $776.25
| Professional | | $144.54 | $323.59 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $186.21 / $186.21
| Professional | | $186.21 | $186.21 | $186.21 |
- 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 / $416.87 / $549.54
| Professional | | $257.04 | $416.87 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $309.03 / $575.44
| Professional | | $158.49 | $309.03 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $537.03
| Professional | | $512.86 | $512.86 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $436.52 / $741.31
| Professional | | $208.93 | $436.52 | $741.31 |
- 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
- $151.36 / $346.74 / $794.33
| Professional | | $151.36 | $346.74 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $562.34 / $933.25
| Professional | | $524.81 | $562.34 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $446.68 / $691.83
| Facility | | $131.83 | $446.68 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $288.40 / $691.83
| Professional | | $64.57 | $288.40 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $645.65 / $4,265.80
| Facility | | $144.54 | $645.65 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $302.00 / $575.44
| Professional | | $144.54 | $302.00 | $575.44 |