- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $2,818.38 / $8,317.64
| Facility | | $218.78 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $218.78 / $676.08
| Professional | | $173.78 | $218.78 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $457.09 / $870.96
| Professional | | $199.53 | $457.09 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $204.17 / $2,570.40
| Professional | | $173.78 | $204.17 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $870.96 / $977.24
| Facility | | $489.78 | $870.96 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $251.19 / $724.44
| Professional | | $177.83 | $251.19 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $645.65 / $812.83
| Professional | | $309.03 | $645.65 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $257.04 / $302.00
| Professional | | $239.88 | $257.04 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $281.84 / $831.76
| Facility | | $186.21 | $281.84 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $158.49 / $158.49
| Professional | | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $223.87 / $891.25
| Facility | | $181.97 | $223.87 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $245.47 / $1,174.90
| Professional | | $186.21 | $245.47 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,884.03 / $5,754.40
| Facility | | $512.86 | $2,884.03 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $213.80 / $407.38
| Professional | | $144.54 | $213.80 | $407.38 |