- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,467.37 / $7,244.36
| Facility | | $501.19 | $3,467.37 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $426.58 / $851.14
| Professional | | $281.84 | $426.58 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $7,413.10 / $9,332.54
| Facility | | $6,606.93 | $7,413.10 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $467.74 / $741.31
| Professional | | $309.03 | $467.74 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $288.40 / $4,897.79
| Professional | | $251.19 | $288.40 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $2,691.53 / $3,311.31
| Facility | | $426.58 | $2,691.53 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $446.68 / $776.25
| Professional | | $309.03 | $446.68 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $512.86 / $851.14
| Professional | | $416.87 | $512.86 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $524.81 / $660.69
| Professional | | $446.68 | $524.81 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $478.63 / $776.25
| Facility | | $302.00 | $478.63 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $812.83
| Professional | | $380.19 | $380.19 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $363.08 / $2,089.30
| Facility | | $288.40 | $363.08 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $524.81 / $2,137.96
| Professional | | $407.38 | $524.81 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $10,471.29 / $23,988.33
| Facility | | $2,137.96 | $10,471.29 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $426.58 / $724.44
| Professional | | $269.15 | $426.58 | $724.44 |