- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.56 / $4,785.49 / $8,347.51
| Facility | | $391.56 | $4,785.49 | $8,347.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.15 / $331.63 / $1,082.00
| Professional | | $191.15 | $331.63 | $1,082.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,487.79 / $1,487.79 / $2,310.00
| Facility | | $1,487.79 | $1,487.79 | $2,310.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.62 / $525.13 / $1,322.03
| Professional | | $299.62 | $525.13 | $1,322.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $365.29 / $536.69 / $1,193.64
| Professional | | $365.29 | $536.69 | $1,193.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.92 / $483.37 / $1,235.05
| Facility | | $294.92 | $483.37 | $1,235.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.32 / $506.55 / $1,238.72
| Professional | | $328.32 | $506.55 | $1,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $379.90 / $873.68 / $990.93
| Facility | | $379.90 | $873.68 | $990.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.92 / $528.69 / $1,704.06
| Facility | | $294.92 | $528.69 | $1,704.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $369.92 / $613.11 / $1,298.04
| Professional | | $369.92 | $613.11 | $1,298.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,389.68 / $5,951.19 / $7,123.24
| Facility | | $4,389.68 | $5,951.19 | $7,123.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $372.26 / $822.18 / $1,357.42
| Professional | | $372.26 | $822.18 | $1,357.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $585.48 / $5,130.00 / $7,233.00
| Facility | | $585.48 | $5,130.00 | $7,233.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.44 / $954.60 / $1,545.72
| Professional | | $549.44 | $954.60 | $1,545.72 |