- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.98 / $1,105.48 / $14,464.32
| Facility | | $511.98 | $1,105.48 | $14,464.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.38 / $410.97 / $885.62
| Professional | | $275.38 | $410.97 | $885.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,241.82 / $7,873.79 / $15,720.23
| Facility | | $1,241.82 | $7,873.79 | $15,720.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.91 / $827.26 / $2,861.36
| Professional | | $447.91 | $827.26 | $2,861.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $564.00 / $906.00 / $2,846.84
| Facility | | $564.00 | $906.00 | $2,846.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $387.61 / $598.72 / $1,061.68
| Professional | | $387.61 | $598.72 | $1,061.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.95 / $679.20 / $1,918.07
| Facility | | $418.95 | $679.20 | $1,918.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $449.50 / $688.94 / $1,461.44
| Professional | | $449.50 | $688.94 | $1,461.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.48 / $421.53 / $911.57
| Professional | | $45.48 | $421.53 | $911.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.90 / $775.19 / $2,016.07
| Facility | | $543.90 | $775.19 | $2,016.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.04 / $528.75 / $1,241.82
| Facility | | $520.04 | $528.75 | $1,241.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $450.72 / $738.17 / $969.22
| Professional | | $450.72 | $738.17 | $969.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,221.67 / $8,047.87 / $15,403.47
| Facility | | $5,221.67 | $8,047.87 | $15,403.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $433.82 / $623.04 / $947.51
| Professional | | $433.82 | $623.04 | $947.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,232.00 / $1,981.00 / $10,522.00
| Facility | | $1,232.00 | $1,981.00 | $10,522.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $465.50 / $579.28 / $1,102.85
| Professional | | $465.50 | $579.28 | $1,102.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.14 / $345.14 / $423.67
| Professional | | $345.14 | $345.14 | $423.67 |