- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $4,073.80 / $8,317.64
| Facility | | $776.25 | $4,073.80 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $371.54 / $912.01
| Professional | | $302.00 | $371.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $389.05 / $676.08
| Professional | | $363.08 | $389.05 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $616.60
| Facility | | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $426.58 / $724.44
| Professional | | $309.03 | $426.58 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $524.81 / $676.08
| Professional | | $389.05 | $524.81 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $426.58 / $676.08
| Professional | | $323.59 | $426.58 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $5,495.41 / $7,244.36
| Facility | | $3,981.07 | $5,495.41 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $436.52 / $436.52
| Professional | | $436.52 | $436.52 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $3,630.78 / $8,317.64
| Facility | | $776.25 | $3,630.78 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $478.63 / $1,202.26
| Professional | | $323.59 | $478.63 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $724.44
| Facility | | $512.86 | $512.86 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $512.86 / $741.31
| Professional | | $457.09 | $512.86 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $407.38 / $467.74
| Facility | | $354.81 | $407.38 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $407.38 / $467.74
| Professional | | $338.84 | $407.38 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,187.76 / $5,128.61
| Facility | | $501.19 | $2,187.76 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $407.38 / $691.83
| Professional | | $302.00 | $407.38 | $691.83 |