- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,981.07 / $8,317.64
| Facility | | $1,047.13 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $524.81 / $1,258.93
| Professional | | $380.19 | $524.81 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $588.84 / $812.83
| Professional | | $407.38 | $588.84 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $549.54 / $912.01
| Professional | | $371.54 | $549.54 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $691.83 / $758.58
| Professional | | $537.03 | $691.83 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $588.84 / $831.76
| Professional | | $398.11 | $588.84 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,818.38 / $8,317.64
| Facility | | $954.99 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $602.56 / $1,548.82
| Professional | | $436.52 | $602.56 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $1,023.29
| Facility | | $467.74 | $467.74 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $794.33 / $954.99
| Professional | | $426.58 | $794.33 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $407.38 / $467.74
| Facility | | $398.11 | $407.38 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $407.38 / $478.63
| Professional | | $398.11 | $407.38 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $18,197.01
| Facility | | $1,348.96 | $3,548.13 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $489.78 / $891.25
| Professional | | $346.74 | $489.78 | $891.25 |