- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $6,918.31 / $8,709.64
| Facility | | $1,412.54 | $6,918.31 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $239.88 / $354.81
| Professional | | $190.55 | $239.88 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,548.13 / $8,128.31
| Facility | | $1,380.38 | $3,548.13 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $389.05 / $407.38
| Professional | | $331.13 | $389.05 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $316.23 / $380.19
| Professional | | $218.78 | $316.23 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $407.38 / $7,079.46
| Facility | | $234.42 | $407.38 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $316.23 / $407.38
| Professional | | $204.17 | $316.23 | $407.38 |
- 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
- $5,128.61 / $7,079.46 / $9,772.37
| Facility | | $5,128.61 | $7,079.46 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $331.13 / $389.05
| Professional | | $281.84 | $331.13 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $323.59 / $7,413.10
| Professional | | $165.96 | $323.59 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $12,302.69 / $12,302.69
| Facility | | $5,495.41 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $257.04 / $380.19
| Professional | | $181.97 | $257.04 | $380.19 |