- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,466.84 / $5,495.41
| Facility | | $2,884.03 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $288.40 / $645.65
| Professional | | $208.93 | $288.40 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $5,754.40 / $8,317.64
| Facility | | $3,235.94 | $5,754.40 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $380.19 / $416.87
| Professional | | $323.59 | $380.19 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $371.54 / $426.58
| Professional | | $281.84 | $371.54 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $436.52 / $4,466.84
| Facility | | $263.03 | $436.52 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $338.84 / $426.58
| Professional | | $295.12 | $338.84 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $7,244.36 / $10,471.29
| Facility | | $5,754.40 | $7,244.36 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $407.38 / $436.52
| Professional | | $398.11 | $407.38 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $323.59 / $7,585.78
| Professional | | $169.82 | $323.59 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $17,782.79 / $19,054.61
| Facility | | $9,332.54 | $17,782.79 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $288.40 / $446.68
| Professional | | $218.78 | $288.40 | $446.68 |