- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,466.84 / $5,495.41
| Facility | | $2,884.03 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $407.38 / $588.84
| Professional | | $295.12 | $407.38 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,786.30 / $8,128.31
| Facility | | $2,344.23 | $4,786.30 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $660.69 / $676.08
| Professional | | $549.54 | $660.69 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $524.81 / $645.65
| Professional | | $363.08 | $524.81 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $616.60 / $2,884.03
| Facility | | $338.84 | $616.60 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $537.03 / $676.08
| Professional | | $338.84 | $537.03 | $676.08 |
- 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
- $467.74 / $549.54 / $660.69
| Professional | | $467.74 | $549.54 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $537.03 / $7,413.10
| Professional | | $281.84 | $537.03 | $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
- $309.03 / $436.52 / $630.96
| Professional | | $309.03 | $436.52 | $630.96 |