- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,466.84 / $5,495.41
| Facility | | $2,884.03 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $213.80 / $446.68
| Professional | | $181.97 | $213.80 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,981.07 / $9,772.37
| Facility | | $1,737.80 | $3,981.07 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $371.54 / $389.05
| Professional | | $323.59 | $371.54 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $295.12 / $407.38
| Professional | | $186.21 | $295.12 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $288.40 / $575.44
| Facility | | $190.55 | $288.40 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $323.59 / $380.19
| Professional | | $199.53 | $323.59 | $380.19 |
- 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
- $5,754.40 / $7,585.78 / $10,232.93
| Facility | | $5,754.40 | $7,585.78 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $363.08 / $398.11
| Professional | | $288.40 | $363.08 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $186.21 / $8,317.64
| Professional | | $165.96 | $186.21 | $8,317.64 |
- 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
- $181.97 / $263.03 / $398.11
| Professional | | $181.97 | $263.03 | $398.11 |