- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $4,786.30 / $8,317.64
| Facility | | $331.13 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $208.93 / $524.81
| Professional | | $173.78 | $208.93 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $257.04 / $389.05
| Professional | | $186.21 | $257.04 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $213.80 / $3,311.31
| Professional | | $186.21 | $213.80 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,412.54 / $1,412.54
| Facility | | $489.78 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $245.47 / $426.58
| Professional | | $181.97 | $245.47 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $213.80 / $436.52
| Professional | | $173.78 | $213.80 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $281.84 / $407.38
| Professional | | $234.42 | $281.84 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $257.04 / $389.05
| Facility | | $190.55 | $257.04 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $426.58
| Professional | | $204.17 | $204.17 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $234.42 / $891.25
| Facility | | $190.55 | $234.42 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $234.42 / $891.25
| Professional | | $190.55 | $234.42 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $6,025.60 / $13,803.84
| Facility | | $1,071.52 | $6,025.60 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $218.78 / $371.54
| Professional | | $151.36 | $218.78 | $371.54 |