- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.30 / $1,054.33 / $7,920.26
| Facility | | $596.30 | $1,054.33 | $7,920.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.44 / $475.49 / $1,279.14
| Professional | | $290.44 | $475.49 | $1,279.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.10 / $593.10 / $1,664.70
| Facility | | $593.10 | $593.10 | $1,664.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.27 / $665.89 / $1,260.42
| Professional | | $359.27 | $665.89 | $1,260.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $589.08 / $823.25 / $1,170.85
| Professional | | $589.08 | $823.25 | $1,170.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.43 / $650.25 / $1,044.75
| Facility | | $354.43 | $650.25 | $1,044.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $445.44 / $638.72 / $1,137.60
| Professional | | $445.44 | $638.72 | $1,137.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $462.00 / $780.88 / $952.07
| Facility | | $462.00 | $780.88 | $952.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.43 / $704.70 / $1,217.64
| Facility | | $354.43 | $704.70 | $1,217.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $553.04 / $801.46 / $1,217.64
| Professional | | $553.04 | $801.46 | $1,217.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,382.73 / $10,185.20 / $12,751.18
| Facility | | $7,382.73 | $10,185.20 | $12,751.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $561.91 / $863.17 / $1,248.72
| Professional | | $561.91 | $863.17 | $1,248.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,151.00 / $15,055.00 / $24,231.00
| Facility | | $2,151.00 | $15,055.00 | $24,231.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $600.60 / $858.94 / $1,470.09
| Professional | | $600.60 | $858.94 | $1,470.09 |