- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $7,585.78 / $11,220.18
| Facility | | $1,412.54 | $7,585.78 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $338.84 / $1,122.02
| Professional | | $263.03 | $338.84 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $21,379.62 / $57,543.99
| Facility | | $20,417.38 | $21,379.62 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $407.38 / $489.78
| Professional | | $251.19 | $407.38 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $380.19 / $575.44
| Professional | | $295.12 | $380.19 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $446.68
| Professional | | $389.05 | $389.05 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $380.19 / $549.54
| Professional | | $302.00 | $380.19 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $6,606.93 / $11,220.18
| Facility | | $1,047.13 | $6,606.93 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $363.08 / $1,445.44
| Professional | | $295.12 | $363.08 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $6.03 / $707.95
| Professional | | $6.03 | $6.03 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $309.03 / $316.23
| Facility | | $275.42 | $309.03 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $281.84 / $588.84
| Professional | | $107.15 | $281.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,570.40 / $6,760.83
| Facility | | $660.69 | $2,570.40 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $354.81 / $575.44
| Professional | | $263.03 | $354.81 | $575.44 |