- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $349.85 / $1,170.40 / $1,855.51
| Facility | | $349.85 | $1,170.40 | $1,855.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.40 / $370.75 / $1,104.24
| Professional | | $338.40 | $370.75 | $1,104.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.98 / $580.70 / $1,593.27
| Facility | | $375.98 | $580.70 | $1,593.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.58 / $508.87 / $2,017.99
| Professional | | $262.58 | $508.87 | $2,017.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.48 / $1,088.70 / $2,022.10
| Facility | | $372.48 | $1,088.70 | $2,022.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.34 / $478.34 / $499.78
| Professional | | $478.34 | $478.34 | $499.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.77 / $621.85 / $1,157.70
| Facility | | $330.77 | $621.85 | $1,157.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.72 / $536.71 / $1,326.16
| Professional | | $256.72 | $536.71 | $1,326.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,472.00 / $9,239.00
| Facility | | $83.43 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $734.20 / $734.20 / $863.76
| Professional | | $734.20 | $734.20 | $863.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.87 / $508.87 / $1,575.92
| Professional | | $508.87 | $508.87 | $1,575.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $885.43 / $2,417.13 / $2,417.13
| Facility | | $885.43 | $2,417.13 | $2,417.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.87 / $305.32 / $2,544.35
| Professional | | $299.87 | $305.32 | $2,544.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.62 / $305.32 / $908.87
| Professional | | $299.62 | $305.32 | $908.87 |