- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $2,570.40 / $7,079.46
| Facility | | $363.08 | $2,570.40 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $389.05 / $691.83
| Professional | | $204.17 | $389.05 | $691.83 |
- 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
- $218.78 / $398.11 / $676.08
| Professional | | $218.78 | $398.11 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $245.47 / $2,570.40
| Professional | | $199.53 | $245.47 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $501.19 / $645.65
| Facility | | $338.84 | $501.19 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $380.19 / $691.83
| Professional | | $223.87 | $380.19 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $537.03 / $891.25
| Professional | | $407.38 | $537.03 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $602.56 / $776.25
| Professional | | $537.03 | $602.56 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $426.58 / $758.58
| Facility | | $223.87 | $426.58 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $954.99
| Professional | | $323.59 | $323.59 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $275.42 / $912.01
| Facility | | $208.93 | $275.42 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $537.03 / $1,698.24
| Professional | | $407.38 | $537.03 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,818.38 / $5,754.40
| Facility | | $512.86 | $2,818.38 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $363.08 / $691.83
| Professional | | $190.55 | $363.08 | $691.83 |