- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.70 / $367.73 / $2,428.31
| Professional | | $257.70 | $367.73 | $2,428.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42.16 / $46.71 / $1,436.06
| Facility | | $42.16 | $46.71 | $1,436.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.10 / $593.84 / $841.62
| Professional | | $467.10 | $593.84 | $841.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $996.06 / $996.06 / $996.06
| Facility | | $996.06 | $996.06 | $996.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $454.87 / $668.36
| Professional | | $100.00 | $454.87 | $668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.79 / $516.79 / $576.26
| Facility | | $516.79 | $516.79 | $576.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.27 / $516.79 / $975.75
| Professional | | $439.27 | $516.79 | $975.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.51 / $691.51 / $829.81
| Professional | | $691.51 | $691.51 | $829.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $504.97 / $589.13 / $1,009.94
| Professional | | $504.97 | $589.13 | $1,009.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,220.34 / $3,947.25 / $3,997.70
| Facility | | $1,220.34 | $3,947.25 | $3,997.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.23 / $523.23 / $841.62
| Facility | | $267.23 | $523.23 | $841.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.27 / $516.79 / $526.50
| Professional | | $439.27 | $516.79 | $526.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,588.54 / $1,588.54 / $1,588.54
| Professional | | $1,588.54 | $1,588.54 | $1,588.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $673.30 / $673.30 / $691.51
| Professional | | $673.30 | $673.30 | $691.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.93 / $419.88 / $719.39
| Professional | | $318.93 | $419.88 | $719.39 |