- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,311.31 / $5,128.61
| Facility | | $1,778.28 | $3,311.31 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $457.09 / $1,513.56
| Professional | | $257.04 | $457.09 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $7,079.46 / $81,283.05
| Facility | | $56.23 | $7,079.46 | $81,283.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $588.84 / $1,548.82
| Professional | | $295.12 | $588.84 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $794.33 / $1,412.54
| Professional | | $478.63 | $794.33 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $707.95 / $7,079.46
| Facility | | $331.13 | $707.95 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $478.63 / $831.76
| Professional | | $389.05 | $478.63 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $9,549.93 / $89,125.09
| Facility | | $2,818.38 | $9,549.93 | $89,125.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $602.56 / $1,202.26
| Professional | | $338.84 | $602.56 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $7,079.46 / $81,283.05
| Facility | | $56.23 | $7,079.46 | $81,283.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $588.84 / $1,548.82
| Professional | | $295.12 | $588.84 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $9,549.93 / $81,283.05
| Facility | | $2,691.53 | $9,549.93 | $81,283.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $660.69 / $1,479.11
| Professional | | $436.52 | $660.69 | $1,479.11 |