- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.81 / $499.20 / $3,101.39
| Facility | | $436.81 | $499.20 | $3,101.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.02 / $436.81 / $2,663.20
| Professional | | $291.02 | $436.81 | $2,663.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41.35 / $570.00 / $2,021.64
| Facility | | $41.35 | $570.00 | $2,021.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.93 / $480.24 / $1,086.84
| Professional | | $311.93 | $480.24 | $1,086.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $480.31 / $2,356.67
| Facility | | $59.40 | $480.31 | $2,356.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $353.13 / $547.53 / $1,163.43
| Professional | | $353.13 | $547.53 | $1,163.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.74 / $4,112.77 / $9,136.87
| Facility | | $810.74 | $4,112.77 | $9,136.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.66 / $527.33 / $1,340.56
| Professional | | $325.66 | $527.33 | $1,340.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.82 / $535.13 / $722.43
| Professional | | $217.82 | $535.13 | $722.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.93 / $522.48 / $934.28
| Professional | | $393.93 | $522.48 | $934.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $844.97 / $4,042.45 / $4,042.45
| Facility | | $844.97 | $4,042.45 | $4,042.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,725.60 / $2,725.60 / $3,359.93
| Professional | | $2,725.60 | $2,725.60 | $3,359.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.58 / $560.57 / $6,412.37
| Facility | | $305.58 | $560.57 | $6,412.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.66 / $496.05 / $1,295.76
| Professional | | $325.66 | $496.05 | $1,295.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,532.44 / $1,532.44 / $1,532.44
| Professional | | $1,532.44 | $1,532.44 | $1,532.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.72 / $443.37 / $595.16
| Professional | | $326.72 | $443.37 | $595.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,372.92 / $2,303.06 / $2,303.06
| Facility | | $1,372.92 | $2,303.06 | $2,303.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.50 / $462.67 / $1,293.08
| Professional | | $299.50 | $462.67 | $1,293.08 |