- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $10,715.19 / $18,620.87
| Facility | | $295.12 | $10,715.19 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $257.04 / $323.59
| Professional | | $165.96 | $257.04 | $323.59 |
- 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
- $1,230.27 / $1,230.27 / $1,230.27
| Professional | | $1,230.27 | $1,230.27 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $549.54 / $616.60
| Professional | | $416.87 | $549.54 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $426.58 / $18,620.87
| Facility | | $257.04 | $426.58 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $269.15 / $8,912.51
| Professional | | $181.97 | $269.15 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $501.19 / $524.81
| Facility | | $363.08 | $501.19 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $295.12 / $478.63
| Facility | | $165.96 | $295.12 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $537.03 / $1,230.27
| Professional | | $79.43 | $537.03 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $912.01 / $1,071.52
| Facility | | $389.05 | $912.01 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $549.54 / $676.08
| Professional | | $426.58 | $549.54 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $10,232.93 / $37,153.52
| Facility | | $2,454.71 | $10,232.93 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $512.86 / $741.31
| Professional | | $346.74 | $512.86 | $741.31 |