- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $6,165.95 / $7,585.78
| Facility | | $371.54 | $6,165.95 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $363.08 / $954.99
| Professional | | $204.17 | $363.08 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,630.78 / $8,912.51
| Facility | | $1,737.80 | $3,630.78 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $407.38 / $426.58
| Professional | | $354.81 | $407.38 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $316.23 / $446.68
| Professional | | $204.17 | $316.23 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $346.74 / $3,388.44
| Facility | | $218.78 | $346.74 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $354.81 / $549.54
| Professional | | $218.78 | $354.81 | $549.54 |
- 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
- $5,248.07 / $7,585.78 / $10,232.93
| Facility | | $5,248.07 | $7,585.78 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $407.38 / $436.52
| Professional | | $316.23 | $407.38 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $199.53 / $7,762.47
| Professional | | $181.97 | $199.53 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $12,302.69 / $12,302.69
| Facility | | $5,495.41 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $288.40 / $436.52
| Professional | | $204.17 | $288.40 | $436.52 |