- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $7,244.36 / $12,022.64
| Facility | | $1,445.44 | $7,244.36 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $446.68 / $1,584.89
| Professional | | $354.81 | $446.68 | $1,584.89 |
- 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
- $302.00 / $549.54 / $575.44
| Professional | | $302.00 | $549.54 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $549.54 / $741.31
| Professional | | $363.08 | $549.54 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $562.34
| Professional | | $501.19 | $501.19 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $524.81 / $912.01
| Professional | | $398.11 | $524.81 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,863.01 / $47,863.01 / $47,863.01
| Facility | | $47,863.01 | $47,863.01 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $6,025.60 / $12,022.64
| Facility | | $1,288.25 | $6,025.60 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $512.86 / $1,862.09
| Professional | | $389.05 | $512.86 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $660.69 / $912.01
| Professional | | $630.96 | $660.69 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $537.03 / $933.25
| Facility | | $354.81 | $537.03 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $371.54 / $933.25
| Professional | | $309.03 | $371.54 | $933.25 |
- 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
- $346.74 / $489.78 / $794.33
| Professional | | $346.74 | $489.78 | $794.33 |