- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $675.45 / $804.71 / $1,973.25
| Professional | | $675.45 | $804.71 | $1,973.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $710.22 / $772.68 / $885.24
| Professional | | $710.22 | $772.68 | $885.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $781.64 / $1,074.97 / $7,965.87
| Professional | | $781.64 | $1,074.97 | $7,965.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $581.65 / $830.93 / $1,819.40
| Professional | | $581.65 | $830.93 | $1,819.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $752.84 / $1,127.24 / $2,972.46
| Professional | | $752.84 | $1,127.24 | $2,972.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $674.96 / $1,054.08 / $1,423.02
| Professional | | $674.96 | $1,054.08 | $1,423.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $732.02 / $948.68 / $1,626.70
| Professional | | $732.02 | $948.68 | $1,626.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,712.10 / $5,712.10 / $6,521.18
| Professional | | $5,712.10 | $5,712.10 | $6,521.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $1,090.24
| Professional | | $32.34 | $32.34 | $1,090.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $800.73 / $1,232.88 / $2,325.98
| Professional | | $800.73 | $1,232.88 | $2,325.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,379.42 / $2,379.42 / $2,379.42
| Professional | | $2,379.42 | $2,379.42 | $2,379.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $852.72 / $959.31 / $1,172.49
| Professional | | $852.72 | $959.31 | $1,172.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.27 / $654.39 / $1,794.36
| Professional | | $311.27 | $654.39 | $1,794.36 |