- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,630.78 / $5,495.41
| Facility | | $1,412.54 | $3,630.78 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $251.19 / $954.99
| Professional | | $70.79 | $251.19 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,187.76 / $4,897.79
| Facility | | $1,122.02 | $2,187.76 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $831.76 / $1,096.48
| Professional | | $128.82 | $831.76 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $234.42 / $1,071.52
| Professional | | $85.11 | $234.42 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $549.54 / $1,513.56
| Facility | | $89.13 | $549.54 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $575.44 / $1,096.48
| Professional | | $89.13 | $575.44 | $1,096.48 |
- 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
- $2,754.23 / $3,890.45 / $6,025.60
| Facility | | $2,754.23 | $3,890.45 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $186.21 / $1,202.26
| Professional | | $109.65 | $186.21 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $501.19 / $3,019.95
| Professional | | $79.43 | $501.19 | $3,019.95 |
- 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
- $79.43 / $478.63 / $1,096.48
| Professional | | $79.43 | $478.63 | $1,096.48 |