- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $4,466.84 / $8,511.38
| Facility | | $537.03 | $4,466.84 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $316.23 / $1,096.48
| Professional | | $190.55 | $316.23 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $467.74 / $549.54
| Professional | | $177.83 | $467.74 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $7,244.36 / $14,125.38
| Facility | | $5,623.41 | $7,244.36 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $346.74 / $501.19
| Professional | | $199.53 | $346.74 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $467.74 / $758.58
| Professional | | $223.87 | $467.74 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $407.38 / $4,265.80
| Facility | | $234.42 | $407.38 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $524.81 / $1,905.46
| Professional | | $338.84 | $524.81 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $602.56 / $758.58
| Professional | | $467.74 | $602.56 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $562.34
| Professional | | $446.68 | $446.68 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $380.19 / $660.69
| Professional | | $3.02 | $380.19 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,365.16 / $8,128.31
| Facility | | $2,570.40 | $4,365.16 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $426.58 / $602.56
| Professional | | $269.15 | $426.58 | $602.56 |