- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $1,621.81 / $7,244.36
| Facility | | $281.84 | $1,621.81 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $398.11 / $1,737.80
| Professional | | $177.83 | $398.11 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,981.07 / $9,120.11
| Facility | | $1,819.70 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $1,122.02 / $1,380.38
| Professional | | $323.59 | $1,122.02 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $354.81 / $1,318.26
| Professional | | $208.93 | $354.81 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $954.99 / $2,454.71
| Facility | | $234.42 | $954.99 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $741.31 / $1,584.89
| Professional | | $223.87 | $741.31 | $1,584.89 |
- 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
- $6,025.60 / $7,762.47 / $11,220.18
| Facility | | $6,025.60 | $7,762.47 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $331.13 / $1,230.27
| Professional | | $234.42 | $331.13 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $676.08 / $6,606.93
| Professional | | $331.13 | $676.08 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $12,302.69 / $12,302.69
| Facility | | $5,495.41 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $602.56 / $1,288.25
| Professional | | $194.98 | $602.56 | $1,288.25 |