- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,388.44 / $5,623.41
| Facility | | $660.69 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $776.25 / $1,905.46
| Professional | | $630.96 | $776.25 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,659.59 / $6,456.54
| Facility | | $56.23 | $1,659.59 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $1,023.29 / $5,011.87
| Professional | | $645.65 | $1,023.29 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $954.99 / $1,412.54 / $1,862.09
| Professional | | $954.99 | $1,412.54 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $741.31 / $1,380.38
| Facility | | $50.12 | $741.31 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $912.01 / $1,905.46
| Professional | | $537.03 | $912.01 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,445.44 / $7,079.46
| Facility | | $501.19 | $1,445.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $977.24 / $1,412.54
| Professional | | $707.95 | $977.24 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $2,454.71 / $4,677.35
| Facility | | $295.12 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $1,230.27 / $1,905.46
| Professional | | $691.83 | $1,230.27 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,659.59 / $6,456.54
| Facility | | $56.23 | $1,659.59 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $1,023.29 / $5,011.87
| Professional | | $645.65 | $1,023.29 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,754.23 / $4,677.35
| Facility | | $794.33 | $2,754.23 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $977.24 / $2,041.74
| Professional | | $660.69 | $977.24 | $2,041.74 |