- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $4,786.30 / $8,317.64
| Facility | | $1,047.13 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $457.09 / $1,412.54
| Professional | | $354.81 | $457.09 | $1,412.54 |
- 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
- $363.08 / $616.60 / $776.25
| Professional | | $363.08 | $616.60 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $524.81 / $776.25
| Professional | | $380.19 | $524.81 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $588.84
| Professional | | $524.81 | $524.81 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $501.19 / $812.83
| Professional | | $398.11 | $501.19 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,801.89 / $8,317.64
| Facility | | $954.99 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $512.86 / $1,412.54
| Professional | | $398.11 | $512.86 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $758.58 / $977.24
| Professional | | $7.08 | $758.58 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $371.54
| Facility | | $354.81 | $354.81 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $354.81 / $467.74
| Professional | | $275.42 | $354.81 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $26,915.35 / $79,432.82
| Facility | | $3,890.45 | $26,915.35 | $79,432.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $489.78 / $794.33
| Professional | | $363.08 | $489.78 | $794.33 |