- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $1,548.82 / $9,549.93
| Facility | | $257.04 | $1,548.82 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $380.19 / $891.25
| Professional | | $245.47 | $380.19 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $588.84 / $1,380.38
| Professional | | $354.81 | $588.84 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,202.26 / $1,905.46
| Facility | | $1,023.29 | $1,202.26 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $954.99 / $1,819.70
| Professional | | $398.11 | $954.99 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $489.78 / $3,548.13
| Facility | | $269.15 | $489.78 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $707.95 / $1,047.13
| Professional | | $489.78 | $707.95 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $537.03 / $4,786.30
| Facility | | $269.15 | $537.03 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $794.33 / $2,884.03
| Professional | | $371.54 | $794.33 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $354.81
| Professional | | $32.36 | $33.11 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $812.83 / $1,258.93
| Professional | | $478.63 | $812.83 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,981.07 / $3,981.07
| Facility | | $2,754.23 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $1,949.84 / $2,754.23
| Professional | | $467.74 | $1,949.84 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $1,698.24 / $2,454.71
| Professional | | $588.84 | $1,698.24 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,456.54
| Facility | | $2,884.03 | $3,801.89 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $512.86 / $1,412.54
| Professional | | $295.12 | $512.86 | $1,412.54 |