- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,548.13 / $12,022.64
| Facility | | $812.83 | $3,548.13 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $416.87 / $691.83
| Professional | | $354.81 | $416.87 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $9,549.93 / $18,620.87
| Facility | | $5,248.07 | $9,549.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $416.87 / $588.84
| Professional | | $354.81 | $416.87 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $8,511.38 / $8,511.38
| Facility | | $354.81 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $549.54 / $891.25
| Professional | | $380.19 | $549.54 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,512.09 / $45,708.82 / $45,708.82
| Facility | | $29,512.09 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,981.07 / $3,981.07 / $3,981.07
| Professional | | $3,981.07 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $645.65 / $3,890.45
| Facility | | $380.19 | $645.65 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $489.78 / $660.69
| Professional | | $354.81 | $489.78 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $50.12 / $331.13
| Professional | | $32.36 | $50.12 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $794.33 / $794.33
| Professional | | $724.44 | $794.33 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $562.34 / $912.01
| Facility | | $380.19 | $562.34 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $537.03 / $870.96
| Professional | | $363.08 | $537.03 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $8,317.64 / $17,378.01
| Facility | | $2,630.27 | $8,317.64 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $426.58 / $676.08
| Professional | | $323.59 | $426.58 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $371.54 / $371.54
| Professional | | $354.81 | $371.54 | $371.54 |