- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,691.53 / $3,715.35
| Facility | | $436.52 | $2,691.53 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $467.74 / $1,318.26
| Professional | | $269.15 | $467.74 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $3,981.07 / $28,840.32
| Facility | | $645.65 | $3,981.07 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $549.54 / $1,380.38
| Professional | | $288.40 | $549.54 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $707.95
| Facility | | $309.03 | $309.03 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $630.96 / $1,412.54
| Professional | | $346.74 | $630.96 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $512.86 / $7,079.46
| Facility | | $245.47 | $512.86 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $537.03 / $794.33
| Professional | | $281.84 | $537.03 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $549.54 / $1,174.90
| Professional | | $295.12 | $549.54 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,090.30 / $3,090.30
| Facility | | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,265.80 / $28,840.32
| Facility | | $645.65 | $4,265.80 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $549.54 / $1,380.38
| Professional | | $288.40 | $549.54 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,981.07 / $9,120.11
| Facility | | $1,862.09 | $3,981.07 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $616.60 / $1,230.27
| Professional | | $309.03 | $616.60 | $1,230.27 |