- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.35 / $1,030.23 / $7,920.26
| Facility | | $511.35 | $1,030.23 | $7,920.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.33 / $383.24 / $1,111.48
| Professional | | $228.33 | $383.24 | $1,111.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.14 / $687.60 / $1,134.43
| Professional | | $398.14 | $687.60 | $1,134.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $505.58 / $684.82 / $1,004.52
| Professional | | $505.58 | $684.82 | $1,004.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.40 / $625.87 / $1,043.01
| Facility | | $376.40 | $625.87 | $1,043.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.96 / $649.54 / $1,119.72
| Professional | | $412.96 | $649.54 | $1,119.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.04 / $740.35 / $831.47
| Facility | | $428.04 | $740.35 | $831.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.40 / $801.24 / $2,327.00
| Facility | | $376.40 | $801.24 | $2,327.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.13 / $748.44 / $1,133.24
| Professional | | $485.13 | $748.44 | $1,133.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,536.02 / $8,364.56 / $10,637.18
| Facility | | $6,536.02 | $8,364.56 | $10,637.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.68 / $766.94 / $1,181.53
| Professional | | $503.68 | $766.94 | $1,181.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,689.00 / $5,130.00 / $7,385.00
| Facility | | $1,689.00 | $5,130.00 | $7,385.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $601.03 / $855.96 / $1,326.67
| Professional | | $601.03 | $855.96 | $1,326.67 |