- 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
- $269.15 / $323.59 / $1,348.96
| Professional | | $269.15 | $323.59 | $1,348.96 |
- 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
- $263.03 / $446.68 / $549.54
| Professional | | $263.03 | $446.68 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $398.11 / $537.03
| Professional | | $269.15 | $398.11 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $436.52
| Professional | | $389.05 | $389.05 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $371.54 / $562.34
| Professional | | $316.23 | $371.54 | $562.34 |
- 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
- $281.84 / $363.08 / $1,071.52
| Professional | | $281.84 | $363.08 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.00 / $10.00 / $660.69
| Professional | | $10.00 | $10.00 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $263.03 / $331.13
| Facility | | $263.03 | $263.03 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $309.03 / $758.58
| Professional | | $251.19 | $309.03 | $758.58 |
- 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
- $257.04 / $363.08 / $562.34
| Professional | | $257.04 | $363.08 | $562.34 |