- 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
- $151.36 / $199.53 / $512.86
| Professional | | $151.36 | $199.53 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,365.16 / $7,244.36
| Facility | | $1,995.26 | $4,365.16 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $338.84 / $354.81
| Professional | | $295.12 | $338.84 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $269.15 / $389.05
| Professional | | $169.82 | $269.15 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $263.03 / $512.86
| Facility | | $177.83 | $263.03 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $323.59 / $363.08
| Professional | | $190.55 | $323.59 | $363.08 |
- 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
- $4,073.80 / $5,754.40 / $8,912.51
| Facility | | $4,073.80 | $5,754.40 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $338.84 / $380.19
| Professional | | $263.03 | $338.84 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $177.83 / $5,248.07
| Professional | | $162.18 | $177.83 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $12,302.69 / $12,302.69
| Facility | | $5,495.41 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $234.42 / $354.81
| Professional | | $169.82 | $234.42 | $354.81 |