- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.42 / $884.68 / $2,846.03
| Facility | | $305.42 | $884.68 | $2,846.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.29 / $305.42 / $443.93
| Professional | | $291.29 | $305.42 | $443.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.60 / $567.70 / $1,534.06
| Facility | | $294.60 | $567.70 | $1,534.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.78 / $322.95 / $786.67
| Professional | | $193.78 | $322.95 | $786.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $568.92 / $905.98 / $1,583.88
| Facility | | $568.92 | $905.98 | $1,583.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.58 / $303.58 / $410.14
| Professional | | $303.58 | $303.58 | $410.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.68 / $487.24 / $1,246.82
| Facility | | $225.68 | $487.24 | $1,246.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.19 / $370.87 / $589.82
| Professional | | $190.19 | $370.87 | $589.82 |
- 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
- $465.81 / $465.81 / $548.02
| Professional | | $465.81 | $465.81 | $548.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.95 / $447.62 / $1,202.15
| Professional | | $322.95 | $447.62 | $1,202.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,885.75 / $2,885.75 / $2,885.75
| Facility | | $2,885.75 | $2,885.75 | $2,885.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.70 / $1,534.06 / $1,534.06
| Facility | | $567.70 | $1,534.06 | $1,534.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.33 / $193.78 / $661.08
| Professional | | $145.33 | $193.78 | $661.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.02 / $264.43 / $661.08
| Professional | | $155.02 | $264.43 | $661.08 |