- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $1,288.25 / $2,344.23
| Facility | | $275.42 | $1,288.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $524.81 / $1,548.82
| Professional | | $117.49 | $524.81 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $707.95 / $2,398.83
| Professional | | $213.80 | $707.95 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,041.74 / $3,235.94
| Facility | | $1,737.80 | $2,041.74 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $602.56 / $1,905.46
| Professional | | $190.55 | $602.56 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $691.83 / $3,981.07
| Facility | | $131.83 | $691.83 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $457.09 / $1,819.70
| Professional | | $245.47 | $457.09 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $741.31 / $3,981.07
| Facility | | $134.90 | $741.31 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,258.93 / $2,570.40
| Professional | | $630.96 | $1,258.93 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $467.74
| Professional | | $32.36 | $33.11 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $691.83 / $2,041.74
| Professional | | $229.09 | $691.83 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $2,137.96
| Facility | | $1,445.44 | $1,445.44 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $691.83 / $4,466.84
| Professional | | $162.18 | $691.83 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $1,071.52 / $2,754.23
| Professional | | $323.59 | $1,071.52 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,818.38 / $4,677.35
| Facility | | $2,238.72 | $2,818.38 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $588.84 / $2,089.30
| Professional | | $158.49 | $588.84 | $2,089.30 |