- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $10,715.19 / $18,620.87
| Facility | | $263.03 | $10,715.19 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $234.42 / $295.12
| Professional | | $144.54 | $234.42 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $691.83
| Facility | | $691.83 | $691.83 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Professional | | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $512.86 / $575.44
| Professional | | $398.11 | $512.86 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $309.03 / $13,803.84
| Facility | | $223.87 | $309.03 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $239.88 / $8,912.51
| Professional | | $162.18 | $239.88 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $489.78 / $3,890.45
| Facility | | $407.38 | $489.78 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $269.15 / $457.09
| Facility | | $147.91 | $269.15 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $501.19 / $1,148.15
| Professional | | $79.43 | $501.19 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $912.01 / $15,135.61
| Facility | | $524.81 | $912.01 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $489.78 / $630.96
| Professional | | $371.54 | $489.78 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $16,218.10 / $23,988.33
| Facility | | $2,884.03 | $16,218.10 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $457.09 / $645.65
| Professional | | $323.59 | $457.09 | $645.65 |