- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,691.53 / $8,317.64
| Facility | | $660.69 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $338.84 / $851.14
| Professional | | $263.03 | $338.84 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $489.78 / $707.95
| Professional | | $331.13 | $489.78 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $436.52 / $724.44
| Professional | | $316.23 | $436.52 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $616.60 / $691.83
| Professional | | $478.63 | $616.60 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $489.78 / $707.95
| Professional | | $316.23 | $489.78 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $2,754.23
| Facility | | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,344.23 / $7,762.47
| Facility | | $588.84 | $2,344.23 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $407.38 / $1,096.48
| Professional | | $269.15 | $407.38 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $776.25
| Facility | | $501.19 | $501.19 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $691.83 / $851.14
| Professional | | $416.87 | $691.83 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $371.54 / $426.58
| Facility | | $239.88 | $371.54 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $363.08 / $426.58
| Professional | | $239.88 | $363.08 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $812.83 / $3,890.45
| Facility | | $223.87 | $812.83 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $407.38 / $676.08
| Professional | | $295.12 | $407.38 | $676.08 |