- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $501.19 / $1,905.46
| Facility | | $245.47 | $501.19 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $316.23 / $537.03
| Professional | | $162.18 | $316.23 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $380.19 / $812.83
| Professional | | $245.47 | $380.19 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,047.13 / $1,659.59
| Facility | | $891.25 | $1,047.13 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $549.54 / $1,230.27
| Professional | | $269.15 | $549.54 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $446.68 / $3,548.13
| Facility | | $181.97 | $446.68 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $549.54 / $912.01
| Professional | | $354.81 | $549.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $478.63 / $4,168.69
| Facility | | $181.97 | $478.63 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $741.31 / $3,090.30
| Professional | | $338.84 | $741.31 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $416.87
| Professional | | $32.36 | $33.11 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $512.86 / $1,071.52
| Professional | | $263.03 | $512.86 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,630.27 / $2,630.27
| Facility | | $891.25 | $2,630.27 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $831.76 / $3,162.28
| Professional | | $269.15 | $831.76 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $741.31
| Facility | | $741.31 | $741.31 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $1,621.81 / $3,235.94
| Professional | | $758.58 | $1,621.81 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,090.30 / $5,011.87
| Facility | | $2,398.83 | $3,090.30 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $426.58 / $1,318.26
| Professional | | $181.97 | $426.58 | $1,318.26 |