- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $449.30 / $1,476.25 / $1,956.10
| Facility | | $449.30 | $1,476.25 | $1,956.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.02 / $449.30 / $577.66
| Professional | | $422.02 | $449.30 | $577.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.26 / $734.01 / $2,009.63
| Facility | | $474.26 | $734.01 | $2,009.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.11 / $641.85 / $2,545.34
| Professional | | $385.11 | $641.85 | $2,545.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.85 / $917.85 / $1,721.44
| Facility | | $641.85 | $917.85 | $1,721.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.34 / $603.34 / $603.34
| Professional | | $603.34 | $603.34 | $603.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.30 / $458.92 / $1,460.20
| Facility | | $400.30 | $458.92 | $1,460.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.41 / $616.15 / $1,252.13
| Professional | | $340.41 | $616.15 | $1,252.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,504.00 / $9,239.00
| Facility | | $83.43 | $3,504.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $926.02 / $926.02 / $1,089.44
| Professional | | $926.02 | $926.02 | $1,089.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $641.85 / $641.85 / $1,431.33
| Professional | | $641.85 | $641.85 | $1,431.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,116.82 / $3,048.79 / $3,048.79
| Facility | | $1,116.82 | $3,048.79 | $3,048.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.83 / $385.11 / $3,196.41
| Professional | | $287.83 | $385.11 | $3,196.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.83 / $385.11 / $1,146.38
| Professional | | $287.83 | $385.11 | $1,146.38 |