- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $5,370.32 / $10,964.78
| Facility | | $1,819.70 | $5,370.32 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $239.88 / $302.00
| Professional | | $186.21 | $239.88 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $7,762.47 / $13,803.84
| Facility | | $3,981.07 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $275.42 / $436.52
| Professional | | $234.42 | $275.42 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $16,595.87
| Facility | | $371.54 | $371.54 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $371.54
| Professional | | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $50,118.72
| Facility | | $549.54 | $549.54 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $1,412.54
| Professional | | $1,412.54 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Facility | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $263.03 / $588.84
| Professional | | $20.42 | $263.03 | $588.84 |
- 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
- $2,398.83 / $5,888.44 / $13,489.63
| Facility | | $2,398.83 | $5,888.44 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $363.08 / $831.76
| Professional | | $239.88 | $363.08 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $263.03 / $263.03
| Facility | | $19.05 | $263.03 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.39 / $263.03 / $549.54
| Professional | | $22.39 | $263.03 | $549.54 |