- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $4,168.69 / $8,317.64
| Facility | | $562.34 | $4,168.69 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $512.86 / $1,096.48
| Professional | | $354.81 | $512.86 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,570.40 / $2,951.21
| Facility | | $2,137.96 | $2,570.40 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $575.44 / $851.14
| Professional | | $380.19 | $575.44 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $812.83 / $1,071.52
| Professional | | $371.54 | $812.83 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $1,862.09
| Facility | | $616.60 | $616.60 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $537.03 / $891.25
| Professional | | $371.54 | $537.03 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $691.83 / $812.83
| Professional | | $524.81 | $691.83 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $741.31
| Professional | | $588.84 | $588.84 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $537.03 / $812.83
| Facility | | $380.19 | $537.03 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $977.24 / $977.24
| Professional | | $977.24 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $489.78 / $4,073.80
| Facility | | $323.59 | $489.78 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $676.08 / $4,073.80
| Professional | | $446.68 | $676.08 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,202.26 / $2,511.89
| Facility | | $229.09 | $1,202.26 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $489.78 / $812.83
| Professional | | $316.23 | $489.78 | $812.83 |