- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,096.48 / $13,182.57
| Facility | | $851.14 | $1,096.48 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $501.19 / $977.24
| Professional | | $389.05 | $501.19 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $933.25 / $1,318.26
| Professional | | $478.63 | $933.25 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $794.33 / $1,047.13
| Professional | | $602.56 | $794.33 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $645.65 / $1,445.44
| Facility | | $467.74 | $645.65 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $707.95 / $1,122.02
| Professional | | $616.60 | $707.95 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $776.25 / $870.96
| Facility | | $616.60 | $776.25 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $575.44 / $977.24
| Facility | | $446.68 | $575.44 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $812.83 / $1,122.02
| Professional | | $79.43 | $812.83 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $9,772.37 / $11,748.98
| Facility | | $7,079.46 | $9,772.37 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $933.25 / $1,174.90
| Professional | | $794.33 | $933.25 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $9,772.37 / $14,125.38
| Facility | | $1,995.26 | $9,772.37 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $794.33 / $1,174.90
| Professional | | $501.19 | $794.33 | $1,174.90 |