- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,380.38 / $6,606.93
| Facility | | $371.54 | $1,380.38 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $281.84 / $1,122.02
| Professional | | $173.78 | $281.84 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $1,659.59
| Facility | | $1,479.11 | $1,479.11 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $407.38 / $1,288.25
| Professional | | $194.98 | $407.38 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $489.78 / $1,318.26
| Professional | | $331.13 | $489.78 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $398.11 / $912.01
| Facility | | $190.55 | $398.11 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $398.11 / $1,288.25
| Professional | | $295.12 | $398.11 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $870.96 / $1,071.52
| Facility | | $302.00 | $870.96 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $338.84 / $870.96
| Facility | | $181.97 | $338.84 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $426.58 / $1,348.96
| Professional | | $79.43 | $426.58 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $6,025.60 / $7,244.36
| Facility | | $4,365.16 | $6,025.60 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $467.74 / $1,380.38
| Professional | | $354.81 | $467.74 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $5,495.41 / $7,413.10
| Facility | | $1,548.82 | $5,495.41 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $371.54 / $831.76
| Professional | | $229.09 | $371.54 | $831.76 |