- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,884.03 / $5,128.61
| Facility | | $1,513.56 | $2,884.03 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $501.19 / $1,288.25
| Professional | | $407.38 | $501.19 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,630.78 / $28,840.32
| Facility | | $1,023.29 | $3,630.78 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $691.83 / $3,981.07
| Professional | | $398.11 | $691.83 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $724.44 / $1,202.26
| Professional | | $467.74 | $724.44 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $912.01 / $7,079.46
| Facility | | $426.58 | $912.01 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $588.84 / $831.76
| Professional | | $467.74 | $588.84 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $812.83 / $1,318.26
| Professional | | $426.58 | $812.83 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,630.78 / $28,840.32
| Facility | | $1,071.52 | $3,630.78 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $691.83 / $3,981.07
| Professional | | $398.11 | $691.83 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $691.83 / $1,318.26
| Professional | | $436.52 | $691.83 | $1,318.26 |