- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.23 / $1,553.42 / $2,352.87
| Facility | | $451.23 | $1,553.42 | $2,352.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $427.23 / $451.23 / $794.07
| Professional | | $427.23 | $451.23 | $794.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.02 / $772.33 / $2,114.67
| Facility | | $499.02 | $772.33 | $2,114.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.74 / $675.40 / $2,678.39
| Professional | | $387.74 | $675.40 | $2,678.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,073.49 / $1,535.09 / $2,683.73
| Facility | | $1,073.49 | $1,535.09 | $2,683.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $605.94 / $605.94 / $605.94
| Professional | | $605.94 | $605.94 | $605.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.01 / $825.34 / $1,536.54
| Facility | | $439.01 | $825.34 | $1,536.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.54 / $648.36 / $1,761.00
| Professional | | $380.54 | $648.36 | $1,761.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $974.56 / $974.56 / $1,146.54
| Professional | | $974.56 | $974.56 | $1,146.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $675.40 / $675.40 / $2,091.65
| Professional | | $675.40 | $675.40 | $2,091.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.20 / $3,208.15 / $3,208.15
| Facility | | $1,175.20 | $3,208.15 | $3,208.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.74 / $405.24 / $3,377.00
| Professional | | $387.74 | $405.24 | $3,377.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.67 / $405.24 / $1,297.44
| Professional | | $283.67 | $405.24 | $1,297.44 |