- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $3,981.07 / $10,964.78
| Facility | | $1,122.02 | $3,981.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $194.98 / $309.03
| Professional | | $144.54 | $194.98 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,888.44 / $12,302.69
| Facility | | $3,388.44 | $5,888.44 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $281.84 / $660.69
| Professional | | $229.09 | $281.84 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $10,964.78
| Facility | | $380.19 | $380.19 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $380.19
| Professional | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $218.78 / $50,118.72
| Facility | | $218.78 | $218.78 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $1,023.29 / $1,023.29
| Professional | | $436.52 | $1,023.29 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $380.19 / $1,023.29
| Facility | | $302.00 | $380.19 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $478.63 / $676.08
| Professional | | $331.13 | $478.63 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $288.40 / $288.40
| Facility | | $288.40 | $288.40 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $407.38 / $707.95
| Professional | | $257.04 | $407.38 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Professional | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $6,165.95 / $12,302.69
| Facility | | $1,737.80 | $6,165.95 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $302.00 / $645.65
| Professional | | $223.87 | $302.00 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $275.42 / $363.08
| Facility | | $245.47 | $275.42 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $371.54 / $758.58
| Professional | | $245.47 | $371.54 | $758.58 |