- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,466.84 / $5,495.41
| Facility | | $1,412.54 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $281.84 / $707.95
| Professional | | $239.88 | $281.84 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $8,912.51 / $14,791.08
| Facility | | $1,380.38 | $8,912.51 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $501.19 / $512.86
| Professional | | $426.58 | $501.19 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $389.05 / $549.54
| Professional | | $269.15 | $389.05 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $389.05 / $812.83
| Facility | | $257.04 | $389.05 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $416.87 / $524.81
| Professional | | $257.04 | $416.87 | $524.81 |
- 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
- $9,772.37 / $12,882.50 / $18,197.01
| Facility | | $9,772.37 | $12,882.50 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $501.19 / $537.03
| Professional | | $371.54 | $501.19 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $234.42 / $11,481.54
| Professional | | $213.80 | $234.42 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $6,165.95 / $7,762.47
| Facility | | $3,467.37 | $6,165.95 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $371.54 / $562.34
| Professional | | $257.04 | $371.54 | $562.34 |