- 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
- $181.97 / $489.78 / $933.25
| Professional | | $181.97 | $489.78 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,995.26 / $3,548.13
| Facility | | $794.33 | $1,995.26 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $812.83 / $1,071.52
| Professional | | $331.13 | $812.83 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $436.52 / $1,023.29
| Professional | | $223.87 | $436.52 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $562.34 / $1,659.59
| Facility | | $208.93 | $562.34 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $478.63 / $1,202.26
| Professional | | $263.03 | $478.63 | $1,202.26 |
- 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
- $1,698.24 / $2,398.83 / $3,715.35
| Facility | | $1,698.24 | $2,398.83 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $489.78 / $1,122.02
| Professional | | $288.40 | $489.78 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $562.34 / $1,862.09
| Professional | | $181.97 | $562.34 | $1,862.09 |
- 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
- $208.93 / $501.19 / $1,023.29
| Professional | | $208.93 | $501.19 | $1,023.29 |