- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $537.03 / $14,454.40
| Facility | | $257.04 | $537.03 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $275.42 / $812.83
| Professional | | $245.47 | $275.42 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $8,709.64 / $11,220.18
| Facility | | $4,786.30 | $8,709.64 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $537.03 / $1,348.96
| Professional | | $269.15 | $537.03 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $794.33 / $1,258.93
| Facility | | $676.08 | $794.33 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $1,071.52 / $1,230.27
| Professional | | $380.19 | $1,071.52 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $537.03 / $6,456.54
| Facility | | $263.03 | $537.03 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $630.96 / $812.83
| Professional | | $467.74 | $630.96 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $575.44 / $1,778.28
| Facility | | $263.03 | $575.44 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $512.86 / $3,467.37
| Professional | | $295.12 | $512.86 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $562.34 / $831.76
| Professional | | $363.08 | $562.34 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,454.71 / $2,454.71
| Facility | | $676.08 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $2,187.76 / $3,467.37
| Professional | | $467.74 | $2,187.76 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $870.96 / $870.96
| Professional | | $870.96 | $870.96 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $1,479.11 / $1,659.59
| Professional | | $758.58 | $1,479.11 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,584.89 / $2,137.96
| Facility | | $1,023.29 | $1,584.89 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $416.87 / $1,122.02
| Professional | | $288.40 | $416.87 | $1,122.02 |