- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $4,466.84 / $5,495.41
| Facility | | $4,365.16 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $457.09 / $758.58
| Professional | | $338.84 | $457.09 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,786.30 / $17,782.79
| Facility | | $2,454.71 | $4,786.30 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $512.86 / $602.56 / $616.60
| Professional | | $512.86 | $602.56 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $489.78 / $588.84
| Professional | | $371.54 | $489.78 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $630.96 / $4,365.16
| Facility | | $354.81 | $630.96 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $501.19 / $616.60
| Professional | | $295.12 | $501.19 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $77.62
| Professional | | $30.20 | $30.20 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $15,488.17 / $21,379.62
| Facility | | $11,220.18 | $15,488.17 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $616.60 / $660.69
| Professional | | $426.58 | $616.60 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $562.34 / $16,218.10
| Professional | | $245.47 | $562.34 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,982.44 / $18,197.01
| Facility | | $9,332.54 | $16,982.44 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $457.09 / $660.69
| Professional | | $316.23 | $457.09 | $660.69 |