- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,466.84 / $5,495.41
| Facility | | $1,412.54 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $338.84 / $501.19
| Professional | | $251.19 | $338.84 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $3,162.28 / $8,128.31
| Facility | | $1,230.27 | $3,162.28 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $562.34 / $575.44
| Professional | | $467.74 | $562.34 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $457.09 / $549.54
| Professional | | $323.59 | $457.09 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $512.86 / $1,905.46
| Facility | | $323.59 | $512.86 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $489.78 / $588.84
| Professional | | $288.40 | $489.78 | $588.84 |
- 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
- $398.11 / $467.74 / $562.34
| Professional | | $398.11 | $467.74 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $478.63 / $7,413.10
| Professional | | $234.42 | $478.63 | $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
- $269.15 / $380.19 / $562.34
| Professional | | $269.15 | $380.19 | $562.34 |