- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $7,943.28 / $16,595.87
| Facility | | $691.83 | $7,943.28 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $562.34 / $954.99
| Professional | | $316.23 | $562.34 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $645.65 / $1,148.15
| Professional | | $407.38 | $645.65 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $645.65 / $794.33
| Professional | | $478.63 | $645.65 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $691.83 / $1,479.11
| Facility | | $338.84 | $691.83 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $758.58 / $1,174.90
| Professional | | $524.81 | $758.58 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $660.69 / $1,047.13
| Facility | | $562.34 | $660.69 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $645.65 / $1,288.25
| Facility | | $346.74 | $645.65 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $676.08 / $1,122.02
| Professional | | $79.43 | $676.08 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $8,912.51 / $10,715.19
| Facility | | $6,606.93 | $8,912.51 | $10,715.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $741.31 / $1,096.48
| Professional | | $602.56 | $741.31 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $9,549.93 / $12,882.50
| Facility | | $1,995.26 | $9,549.93 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $741.31 / $1,148.15
| Professional | | $489.78 | $741.31 | $1,148.15 |