- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $6,456.54 / $16,982.44
| Facility | | $2,089.30 | $6,456.54 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $223.87 / $831.76
| Professional | | $147.91 | $223.87 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $6,165.95 / $13,489.63
| Facility | | $3,630.78 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $234.42 / $616.60
| Professional | | $158.49 | $234.42 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $3,019.95 / $7,762.47
| Facility | | $66.07 | $3,019.95 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $251.19 / $537.03
| Professional | | $173.78 | $251.19 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $263.03 / $489.78
| Professional | | $177.83 | $263.03 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $229.09 / $416.87
| Professional | | $117.49 | $229.09 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $309.03 / $562.34
| Professional | | $181.97 | $309.03 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $28,840.32 / $28,840.32
| Facility | | $6,760.83 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,238.72 / $2,238.72
| Professional | | $1,862.09 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $371.54
| Professional | | $223.87 | $223.87 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $263.03 / $426.58
| Facility | | $169.82 | $263.03 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $263.03 / $501.19
| Professional | | $177.83 | $263.03 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $831.76
| Professional | | $575.44 | $575.44 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $199.53 / $316.23
| Professional | | $147.91 | $199.53 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $7,585.78 / $15,135.61
| Facility | | $4,265.80 | $7,585.78 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $218.78 / $436.52
| Professional | | $147.91 | $218.78 | $436.52 |