- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $3,467.37 / $9,772.37
| Facility | | $354.81 | $3,467.37 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $346.74 / $1,318.26
| Professional | | $123.03 | $346.74 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $7,762.47 / $12,589.25
| Facility | | $3,981.07 | $7,762.47 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $602.56 / $1,479.11
| Professional | | $281.84 | $602.56 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,174.90 / $1,862.09
| Facility | | $1,000.00 | $1,174.90 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $616.60 / $1,348.96
| Professional | | $281.84 | $616.60 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $575.44 / $4,168.69
| Facility | | $208.93 | $575.44 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $575.44 / $1,096.48
| Professional | | $371.54 | $575.44 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $724.44 / $6,165.95
| Facility | | $190.55 | $724.44 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $691.83 / $2,754.23
| Professional | | $371.54 | $691.83 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $524.81
| Professional | | $32.36 | $33.11 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $575.44 / $1,412.54
| Professional | | $309.03 | $575.44 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,120.11 / $9,120.11
| Facility | | $6,165.95 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $5,011.87 / $5,011.87 / $7,244.36
| Facility | 52 | $5,011.87 | $5,011.87 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $794.33 / $2,630.27
| Professional | | $234.42 | $794.33 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $1,047.13 / $2,238.72
| Professional | | $562.34 | $1,047.13 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,606.93
| Facility | | $2,884.03 | $3,801.89 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $512.86 / $1,348.96
| Professional | | $208.93 | $512.86 | $1,348.96 |