- 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
- $316.23 / $446.68 / $1,288.25
| Professional | | $316.23 | $446.68 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $2,818.38 / $5,011.87
| Facility | | $1,230.27 | $2,818.38 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $724.44 / $741.31
| Professional | | $616.60 | $724.44 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $1,122.02
| Facility | | $1,122.02 | $1,122.02 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $489.78 / $616.60
| Professional | | $354.81 | $489.78 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $562.34 / $1,096.48
| Facility | | $354.81 | $562.34 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $676.08 / $933.25
| Professional | | $588.84 | $676.08 | $933.25 |
- 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
- $3,467.37 / $4,365.16 / $6,309.57
| Facility | | $3,467.37 | $4,365.16 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $691.83 / $794.33
| Professional | | $489.78 | $691.83 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $426.58 / $3,801.89
| Professional | | $338.84 | $426.58 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $5,495.41 / $12,302.69
| Facility | | $1,348.96 | $5,495.41 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $537.03 / $724.44
| Professional | | $354.81 | $537.03 | $724.44 |