- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,388.44 / $5,623.41
| Facility | | $501.19 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $489.78 / $1,174.90
| Professional | | $398.11 | $489.78 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,348.96 / $4,677.35
| Facility | | $56.23 | $1,348.96 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $645.65 / $3,019.95
| Professional | | $407.38 | $645.65 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $478.63
| Professional | | $446.68 | $478.63 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $676.08 / $1,380.38
| Facility | | $50.12 | $676.08 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $616.60 / $1,174.90
| Professional | | $346.74 | $616.60 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $645.65 / $7,079.46
| Facility | | $177.83 | $645.65 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $588.84 / $891.25
| Professional | | $426.58 | $588.84 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $741.31 / $1,122.02
| Professional | | $426.58 | $741.31 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,348.96 / $4,677.35
| Facility | | $56.23 | $1,348.96 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $630.96 / $3,019.95
| Professional | | $407.38 | $630.96 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,344.23 / $8,511.38
| Facility | | $676.08 | $2,344.23 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $616.60 / $1,230.27
| Professional | | $407.38 | $616.60 | $1,230.27 |