- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $5,888.44 / $16,595.87
| Facility | | $1,659.59 | $5,888.44 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $575.44 / $2,238.72
| Professional | | $346.74 | $575.44 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,466.84 / $12,022.64
| Facility | | $2,570.40 | $4,466.84 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $512.86 / $1,096.48
| Professional | | $346.74 | $512.86 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $2,570.40 / $6,918.31
| Facility | | $66.07 | $2,570.40 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $537.03 / $1,096.48
| Professional | | $323.59 | $537.03 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,090.30 / $3,090.30
| Facility | | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $562.34 / $1,174.90
| Professional | | $354.81 | $562.34 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $512.86 / $1,148.15
| Professional | | $181.97 | $512.86 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $707.95 / $1,258.93
| Professional | | $407.38 | $707.95 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $19,498.45
| Facility | | $8,912.51 | $8,912.51 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,365.16 / $5,248.07 / $5,248.07
| Professional | | $4,365.16 | $5,248.07 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $870.96
| Professional | | $512.86 | $512.86 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $588.84 / $1,047.13
| Facility | | $380.19 | $588.84 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $575.44 / $1,288.25
| Professional | | $346.74 | $575.44 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,288.25 / $2,041.74
| Professional | | $1,288.25 | $1,288.25 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $346.74 / $724.44
| Professional | | $229.09 | $346.74 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $7,585.78 / $15,135.61
| Facility | | $3,981.07 | $7,585.78 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $478.63 / $1,047.13
| Professional | | $309.03 | $478.63 | $1,047.13 |