- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $4,786.30 / $8,317.64
| Facility | | $1,047.13 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $158.49 / $588.84
| Professional | | $131.83 | $158.49 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $204.17 / $257.04
| Professional | | $173.78 | $204.17 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $181.97 / $281.84
| Professional | | $138.04 | $181.97 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $218.78
| Professional | | $190.55 | $190.55 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $186.21 / $316.23
| Professional | | $151.36 | $186.21 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,801.89 / $8,317.64
| Facility | | $954.99 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $181.97 / $724.44
| Professional | | $144.54 | $181.97 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $234.42 / $331.13
| Professional | | $223.87 | $234.42 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $416.87 / $467.74
| Facility | | $131.83 | $416.87 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $407.38 / $467.74
| Professional | | $131.83 | $407.38 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $5,495.41 / $16,982.44
| Facility | | $2,454.71 | $5,495.41 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $173.78 / $288.40
| Professional | | $125.89 | $173.78 | $288.40 |