- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,818.38 / $8,317.64
| Facility | | $467.74 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $478.63 / $1,122.02
| Professional | | $309.03 | $478.63 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $5,248.07 / $57,543.99
| Facility | | $5,011.87 | $5,248.07 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $512.86 / $660.69
| Professional | | $478.63 | $512.86 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $575.44
| Facility | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $467.74 / $851.14
| Professional | | $316.23 | $467.74 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.60 / $851.14 / $1,071.52
| Professional | | $616.60 | $851.14 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $602.56 / $851.14
| Professional | | $371.54 | $602.56 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $6,760.83 / $16,595.87
| Facility | | $2,691.53 | $6,760.83 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,398.83 / $8,317.64
| Facility | | $512.86 | $2,398.83 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $575.44 / $1,202.26
| Professional | | $331.13 | $575.44 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $1,023.29
| Facility | | $354.81 | $354.81 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $446.68 / $1,071.52
| Professional | | $346.74 | $446.68 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $380.19 / $478.63
| Facility | | $288.40 | $380.19 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $416.87 / $478.63
| Professional | | $309.03 | $416.87 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $8,912.51
| Facility | | $1,348.96 | $3,548.13 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $457.09 / $758.58
| Professional | | $295.12 | $457.09 | $758.58 |