- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,412.54 / $14,454.40
| Facility | | $645.65 | $1,412.54 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $691.83 / $1,584.89
| Professional | | $602.56 | $691.83 | $1,584.89 |
- 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
- $660.69 / $1,348.96 / $3,162.28
| Professional | | $660.69 | $1,348.96 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,137.96 / $3,467.37
| Facility | | $1,862.09 | $2,137.96 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $2,041.74 / $2,344.23
| Professional | | $933.25 | $2,041.74 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $3,801.89 / $7,413.10
| Facility | | $707.95 | $3,801.89 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,698.24 / $2,137.96
| Professional | | $1,230.27 | $1,698.24 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $5,495.41 / $8,317.64
| Facility | | $707.95 | $5,495.41 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $1,096.48 / $5,128.61
| Professional | | $691.83 | $1,096.48 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $933.25
| Professional | | $32.36 | $33.11 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $1,584.89 / $2,290.87
| Professional | | $812.83 | $1,584.89 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,943.28 / $7,943.28
| Facility | | $5,370.32 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $3,311.31 / $5,011.87
| Professional | | $933.25 | $3,311.31 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,311.31 / $3,890.45
| Professional | | $1,862.09 | $3,311.31 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,023.29 / $2,884.03
| Professional | | $630.96 | $1,023.29 | $2,884.03 |