- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,949.84 / $5,495.41
| Facility | | $1,445.44 | $1,949.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $371.54 / $870.96
| Professional | | $173.78 | $371.54 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $2,398.83 / $5,248.07
| Facility | | $1,202.26 | $2,398.83 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $575.44 / $724.44
| Professional | | $309.03 | $575.44 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $346.74 / $660.69
| Professional | | $204.17 | $346.74 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $537.03 / $2,344.23
| Facility | | $213.80 | $537.03 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $354.81 / $724.44
| Professional | | $181.97 | $354.81 | $724.44 |
- 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
- $3,467.37 / $4,570.88 / $6,456.54
| Facility | | $3,467.37 | $4,570.88 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $323.59 / $645.65
| Professional | | $229.09 | $323.59 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $338.84 / $1,949.84
| Professional | | $302.00 | $338.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $6,165.95 / $7,762.47
| Facility | | $3,467.37 | $6,165.95 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $346.74 / $602.56
| Professional | | $186.21 | $346.74 | $602.56 |