- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $7,585.78 / $18,197.01
| Facility | | $3,019.95 | $7,585.78 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $436.52 / $2,290.87
| Professional | | $346.74 | $436.52 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,128.31 / $15,848.93
| Facility | | $4,570.88 | $8,128.31 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $575.44 / $1,122.02
| Professional | | $426.58 | $575.44 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $2,630.27 / $8,709.64
| Facility | | $66.07 | $2,630.27 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $537.03 / $1,071.52
| Professional | | $371.54 | $537.03 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,659.59 / $1,659.59
| Facility | | $1,659.59 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $501.19 / $1,047.13
| Professional | | $371.54 | $501.19 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $478.63 / $645.65
| Professional | | $251.19 | $478.63 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $512.86 / $912.01
| Professional | | $389.05 | $512.86 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $4,786.30 / $45,708.82
| Facility | | $4,786.30 | $4,786.30 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,019.95 / $3,548.13 / $3,548.13
| Professional | | $3,019.95 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $588.84
| Professional | | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $524.81 / $812.83
| Facility | | $407.38 | $524.81 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $524.81 / $1,047.13
| Professional | | $371.54 | $524.81 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,318.26 / $1,318.26
| Professional | | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $426.58 / $537.03
| Professional | | $316.23 | $426.58 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,585.78 / $15,135.61
| Facility | | $3,890.45 | $7,585.78 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $398.11 / $851.14
| Professional | | $302.00 | $398.11 | $851.14 |