- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.47 / $1,316.03 / $1,782.54
| Facility | | $505.47 | $1,316.03 | $1,782.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.77 / $505.47 / $764.08
| Professional | | $473.77 | $505.47 | $764.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533.53 / $824.04 / $1,831.32
| Facility | | $533.53 | $824.04 | $1,831.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.94 / $614.15 / $2,319.50
| Professional | | $350.94 | $614.15 | $2,319.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.86 / $1,584.18 / $2,869.90
| Facility | | $1,030.86 | $1,584.18 | $2,869.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $579.04 / $678.77 / $678.77
| Professional | | $579.04 | $678.77 | $678.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $456.23 / $521.75 / $1,330.67
| Facility | | $456.23 | $521.75 | $1,330.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.94 / $617.03 / $1,524.63
| Professional | | $350.94 | $617.03 | $1,524.63 |
- 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
- $843.88 / $843.88 / $992.80
| Professional | | $843.88 | $843.88 | $992.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.90 / $584.90 / $1,901.95
| Professional | | $584.90 | $584.90 | $1,901.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,017.73 / $2,778.28 / $2,778.28
| Facility | | $1,017.73 | $2,778.28 | $2,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.94 / $433.26 / $2,924.50
| Professional | | $350.94 | $433.26 | $2,924.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.94 / $433.26 / $1,114.85
| Professional | | $350.94 | $433.26 | $1,114.85 |