- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,801.89 / $8,317.64
| Facility | | $724.44 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $562.34 / $1,230.27
| Professional | | $407.38 | $562.34 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $10,000.00 / $57,543.99
| Facility | | $9,549.93 | $10,000.00 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $645.65
| Professional | | $602.56 | $602.56 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $741.31
| Facility | | $741.31 | $741.31 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $616.60 / $1,047.13
| Professional | | $416.87 | $616.60 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $933.25 / $1,174.90
| Professional | | $691.83 | $933.25 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $707.95 / $1,148.15
| Professional | | $501.19 | $707.95 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $15,135.61 / $70,794.58
| Facility | | $9,120.11 | $15,135.61 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $2,691.53 / $8,317.64
| Facility | | $758.58 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $676.08 / $1,479.11
| Professional | | $436.52 | $676.08 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $1,122.02
| Facility | | $467.74 | $467.74 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $588.84 / $1,348.96
| Professional | | $457.09 | $588.84 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $446.68 / $933.25
| Facility | | $407.38 | $446.68 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $446.68 / $691.83
| Professional | | $407.38 | $446.68 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $18,197.01
| Facility | | $1,348.96 | $3,548.13 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $588.84 / $977.24
| Professional | | $407.38 | $588.84 | $977.24 |