- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,466.84 / $5,495.41
| Facility | | $2,884.03 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $549.54 / $1,148.15
| Professional | | $426.58 | $549.54 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $4,265.80 / $8,317.64
| Facility | | $1,905.46 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $724.44 / $776.25
| Professional | | $616.60 | $724.44 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $707.95 / $776.25
| Professional | | $575.44 | $707.95 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $891.25 / $5,495.41
| Facility | | $467.74 | $891.25 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $691.83 / $851.14
| Professional | | $602.56 | $691.83 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $7,244.36 / $10,471.29
| Facility | | $5,623.41 | $7,244.36 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $776.25 / $831.76
| Professional | | $724.44 | $776.25 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $588.84 / $7,585.78
| Professional | | $323.59 | $588.84 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,982.44 / $18,197.01
| Facility | | $9,332.54 | $16,982.44 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $602.56 / $912.01
| Professional | | $398.11 | $602.56 | $912.01 |