- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $912.01 / $13,182.57
| Facility | | $489.78 | $912.01 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $467.74 / $1,148.15
| Professional | | $346.74 | $467.74 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $776.25 / $1,096.48
| Professional | | $489.78 | $776.25 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $758.58 / $933.25
| Professional | | $346.74 | $758.58 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $707.95 / $7,943.28
| Facility | | $489.78 | $707.95 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $741.31 / $1,174.90
| Professional | | $575.44 | $741.31 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $707.95 / $741.31
| Facility | | $575.44 | $707.95 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $630.96 / $954.99
| Facility | | $436.52 | $630.96 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $691.83 / $1,023.29
| Professional | | $79.43 | $691.83 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,232.93 / $12,302.69
| Facility | | $7,762.47 | $10,232.93 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $870.96 / $1,148.15
| Professional | | $676.08 | $870.96 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $12,882.50 / $26,302.68
| Facility | | $2,137.96 | $12,882.50 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $776.25 / $1,071.52
| Professional | | $478.63 | $776.25 | $1,071.52 |