- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,025.60 / $16,595.87
| Facility | | $1,698.24 | $6,025.60 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $354.81 / $741.31
| Professional | | $151.36 | $354.81 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,466.84 / $12,882.50
| Facility | | $2,570.40 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $602.56 / $1,148.15
| Professional | | $263.03 | $602.56 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.57 / $2,290.87 / $12,589.25
| Facility | | $64.57 | $2,290.87 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $398.11 / $794.33
| Professional | | $190.55 | $398.11 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $338.84 / $758.58
| Professional | | $154.88 | $338.84 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $380.19 / $478.63
| Professional | | $120.23 | $380.19 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $263.03 / $489.78
| Professional | | $112.20 | $263.03 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $50,118.72 / $50,118.72
| Facility | | $7,585.78 | $50,118.72 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,344.23 / $2,454.71
| Professional | | $2,344.23 | $2,344.23 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $389.05
| Professional | | $234.42 | $234.42 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $331.13 / $588.84
| Facility | | $141.25 | $331.13 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $346.74 / $758.58
| Professional | | $154.88 | $346.74 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $426.58 / $1,023.29
| Professional | | $426.58 | $426.58 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $478.63 / $724.44
| Professional | | $109.65 | $478.63 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,548.82 / $6,760.83
| Facility | | $588.84 | $1,548.82 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $288.40 / $660.69
| Professional | | $131.83 | $288.40 | $660.69 |