- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $6,025.60 / $9,549.93
| Facility | | $1,380.38 | $6,025.60 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $616.60 / $1,412.54
| Professional | | $501.19 | $616.60 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $707.95 / $1,023.29
| Professional | | $489.78 | $707.95 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $676.08 / $1,096.48
| Professional | | $478.63 | $676.08 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $851.14 / $954.99
| Professional | | $660.69 | $851.14 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $724.44 / $1,023.29
| Professional | | $501.19 | $724.44 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $5,248.07 / $9,549.93
| Facility | | $1,047.13 | $5,248.07 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $741.31 / $1,659.59
| Professional | | $501.19 | $741.31 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $1,122.02
| Facility | | $645.65 | $645.65 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $954.99 / $1,148.15
| Professional | | $562.34 | $954.99 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $549.54 / $691.83
| Facility | | $512.86 | $549.54 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $575.44 / $691.83
| Professional | | $512.86 | $575.44 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,981.07 / $10,964.78
| Facility | | $2,089.30 | $3,981.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $616.60 / $1,122.02
| Professional | | $457.09 | $616.60 | $1,122.02 |