- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $3,715.35 / $8,317.64
| Facility | | $426.58 | $3,715.35 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $346.74 / $794.33
| Professional | | $151.36 | $346.74 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $245.47
| Professional | | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $354.81 / $707.95
| Professional | | $165.96 | $354.81 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $257.04 / $588.84
| Professional | | $72.44 | $257.04 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $478.63 / $741.31
| Professional | | $173.78 | $478.63 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $5,248.07
| Facility | | $1,174.90 | $1,174.90 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,570.40 / $8,317.64
| Facility | | $575.44 | $2,570.40 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $380.19 / $933.25
| Professional | | $162.18 | $380.19 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $812.83
| Facility | | $275.42 | $275.42 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $616.60 / $776.25
| Professional | | $275.42 | $616.60 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $380.19 / $588.84
| Facility | | $61.66 | $380.19 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $389.05 / $467.74
| Professional | | $107.15 | $389.05 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,238.72 / $6,456.54
| Facility | | $467.74 | $2,238.72 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $323.59 / $660.69
| Professional | | $162.18 | $323.59 | $660.69 |