- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,890.45 / $8,317.64
| Facility | | $1,047.13 | $3,890.45 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $269.15 / $660.69
| Professional | | $229.09 | $269.15 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $57,543.99
| Facility | | $3,801.89 | $3,801.89 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $354.81 / $398.11
| Professional | | $323.59 | $354.81 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $436.52 / $436.52
| Facility | | $436.52 | $436.52 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $309.03 / $512.86
| Professional | | $245.47 | $309.03 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $398.11 / $501.19
| Professional | | $288.40 | $398.11 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $316.23 / $512.86
| Professional | | $239.88 | $316.23 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,818.38 / $8,317.64
| Facility | | $954.99 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $354.81 / $912.01
| Professional | | $239.88 | $354.81 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $338.84 / $537.03
| Facility | | $338.84 | $338.84 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $407.38 / $562.34
| Professional | | $380.19 | $407.38 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $380.19 / $407.38
| Facility | | $251.19 | $380.19 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $380.19 / $407.38
| Professional | | $251.19 | $380.19 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,630.27 / $5,754.40
| Facility | | $912.01 | $2,630.27 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $295.12 / $489.78
| Professional | | $218.78 | $295.12 | $489.78 |