- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $2,630.27 / $8,317.64
| Facility | | $398.11 | $2,630.27 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $389.05 / $954.99
| Professional | | $295.12 | $389.05 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $537.03 / $933.25
| Professional | | $371.54 | $537.03 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $549.54 / $5,370.32
| Professional | | $407.38 | $549.54 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $416.87
| Facility | | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $436.52 / $776.25
| Professional | | $338.84 | $436.52 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $457.09 / $537.03
| Professional | | $363.08 | $457.09 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $524.81 / $831.76
| Professional | | $416.87 | $524.81 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $457.09 / $724.44
| Facility | | $346.74 | $457.09 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Professional | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $467.74 / $6,918.31
| Facility | | $323.59 | $467.74 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $467.74 / $6,918.31
| Professional | | $323.59 | $467.74 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $7,079.46 / $13,803.84
| Facility | | $3,630.78 | $7,079.46 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $407.38 / $691.83
| Professional | | $257.04 | $407.38 | $691.83 |