- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $2,691.53 / $5,495.41
| Facility | | $269.15 | $2,691.53 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $389.05 / $1,258.93
| Professional | | $234.42 | $389.05 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $4,897.79 / $28,840.32
| Facility | | $630.96 | $4,897.79 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $398.11 / $954.99
| Professional | | $234.42 | $398.11 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $691.83
| Facility | | $302.00 | $302.00 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $812.83 / $977.24
| Professional | | $512.86 | $812.83 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $489.78 / $954.99
| Professional | | $295.12 | $489.78 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $501.19 / $7,079.46
| Facility | | $239.88 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $338.84 / $524.81
| Professional | | $186.21 | $338.84 | $524.81 |
- 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
- $281.84 / $457.09 / $794.33
| Professional | | $281.84 | $457.09 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,862.09 / $5,888.44
| Facility | | $1,230.27 | $1,862.09 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $562.34 / $630.96
| Professional | | $537.03 | $562.34 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $4,897.79 / $28,840.32
| Facility | | $630.96 | $4,897.79 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $389.05 / $954.99
| Professional | | $234.42 | $389.05 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $426.58 / $891.25
| Professional | | $281.84 | $426.58 | $891.25 |