- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $7,244.36 / $14,454.40
| Facility | | $1,047.13 | $7,244.36 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $549.54 / $1,412.54
| Professional | | $457.09 | $549.54 | $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
- $457.09 / $776.25 / $954.99
| Professional | | $457.09 | $776.25 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $691.83 / $933.25
| Professional | | $489.78 | $691.83 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $676.08 / $758.58
| Professional | | $676.08 | $676.08 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $645.65 / $977.24
| Professional | | $537.03 | $645.65 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $5,370.32 / $13,803.84
| Facility | | $831.76 | $5,370.32 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $616.60 / $1,445.44
| Professional | | $489.78 | $616.60 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $15.14 / $1,122.02
| Professional | | $15.14 | $15.14 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $446.68 / $562.34
| Facility | | $309.03 | $446.68 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $457.09 / $2,041.74
| Professional | | $309.03 | $457.09 | $2,041.74 |
- 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
- $436.52 / $616.60 / $954.99
| Professional | | $436.52 | $616.60 | $954.99 |