- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $954.99 / $13,182.57
| Facility | | $831.76 | $954.99 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $537.03 / $1,148.15
| Professional | | $407.38 | $537.03 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $891.25 / $1,174.90
| Professional | | $537.03 | $891.25 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $794.33 / $977.24
| Professional | | $363.08 | $794.33 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $794.33 / $9,332.54
| Facility | | $524.81 | $794.33 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $812.83 / $1,230.27
| Professional | | $630.96 | $812.83 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $741.31 / $851.14
| Facility | | $645.65 | $741.31 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $707.95 / $1,071.52
| Facility | | $446.68 | $707.95 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $741.31 / $1,071.52
| Professional | | $79.43 | $741.31 | $1,071.52 |
- 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
- $707.95 / $912.01 / $1,230.27
| Professional | | $707.95 | $912.01 | $1,230.27 |
- 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
- $524.81 / $891.25 / $1,202.26
| Professional | | $524.81 | $891.25 | $1,202.26 |