- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,162.28 / $7,943.28
| Facility | | $794.33 | $3,162.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $602.56 / $977.24
| Professional | | $512.86 | $602.56 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $676.08 / $912.01
| Professional | | $537.03 | $676.08 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $524.81 / $537.03
| Facility | | $79.43 | $524.81 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $758.58 / $1,174.90
| Professional | | $562.34 | $758.58 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $28,840.32 / $28,840.32
| Facility | | $8,912.51 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,365.16 / $5,011.87 / $5,011.87
| Professional | | $4,365.16 | $5,011.87 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $794.33 / $3,715.35
| Facility | | $549.54 | $794.33 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $724.44 / $977.24
| Professional | | $512.86 | $724.44 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $74.13 / $489.78
| Professional | | $32.36 | $74.13 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $1,071.52
| Professional | | $831.76 | $831.76 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $724.44 / $1,230.27
| Facility | | $537.03 | $724.44 | $1,230.27 |
- 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
- $1,698.24 / $5,248.07 / $10,964.78
| Facility | | $1,698.24 | $5,248.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $602.56 / $933.25
| Professional | | $446.68 | $602.56 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $562.34 / $562.34
| Professional | | $524.81 | $562.34 | $562.34 |