- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $4,466.84 / $5,495.41
| Facility | | $3,388.44 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $218.78 / $501.19
| Professional | | $177.83 | $218.78 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $6,025.60 / $22,387.21
| Facility | | $4,073.80 | $6,025.60 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $309.03 / $323.59
| Professional | | $263.03 | $309.03 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $281.84 / $338.84
| Professional | | $223.87 | $281.84 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $354.81 / $4,466.84
| Facility | | $213.80 | $354.81 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $275.42 / $371.54
| Professional | | $239.88 | $275.42 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $19,054.61 / $28,183.83
| Facility | | $15,488.17 | $19,054.61 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $331.13 / $354.81
| Professional | | $309.03 | $331.13 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $251.19 / $20,417.38
| Professional | | $131.83 | $251.19 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $26,915.35 / $29,512.09
| Facility | | $11,748.98 | $26,915.35 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $245.47 / $363.08
| Professional | | $181.97 | $245.47 | $363.08 |