- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $5,370.32 / $8,511.38
| Facility | | $1,288.25 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $575.44 / $1,584.89
| Professional | | $467.74 | $575.44 | $1,584.89 |
- 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
- $741.31 / $741.31 / $812.83
| Professional | | $741.31 | $741.31 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $616.60 / $977.24
| Professional | | $446.68 | $616.60 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $831.76
| Professional | | $758.58 | $758.58 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $676.08 / $1,023.29
| Professional | | $467.74 | $676.08 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,570.88 / $8,511.38
| Facility | | $1,023.29 | $4,570.88 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $645.65 / $1,698.24
| Professional | | $501.19 | $645.65 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $575.44 / $954.99
| Professional | | $549.54 | $575.44 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $467.74 / $575.44
| Facility | | $457.09 | $467.74 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $489.78 / $575.44
| Professional | | $446.68 | $489.78 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,981.07 / $9,772.37
| Facility | | $2,089.30 | $3,981.07 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $575.44 / $954.99
| Professional | | $446.68 | $575.44 | $954.99 |