- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $8,317.64 / $14,791.08
| Facility | | $6,456.54 | $8,317.64 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $446.68 / $1,202.26
| Professional | | $346.74 | $446.68 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $457.09
| Professional | | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,232.93 / $19,952.62
| Facility | | $7,762.47 | $10,232.93 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $630.96 / $891.25
| Professional | | $363.08 | $630.96 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $758.58 / $1,288.25
| Professional | | $380.19 | $758.58 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $616.60 / $7,762.47
| Facility | | $371.54 | $616.60 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $776.25 / $7,244.36
| Professional | | $457.09 | $776.25 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $776.25 / $912.01 / $1,288.25
| Professional | | $776.25 | $912.01 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $891.25 / $1,288.25
| Professional | | $676.08 | $891.25 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $588.84 / $1,071.52
| Professional | | $5.01 | $588.84 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $7,413.10 / $9,120.11
| Facility | | $4,677.35 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $602.56 / $1,023.29
| Professional | | $436.52 | $602.56 | $1,023.29 |