- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $4,265.80 / $15,135.61
| Facility | | $1,148.15 | $4,265.80 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $1,288.25 / $2,238.72
| Professional | | $288.40 | $1,288.25 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $1,174.90 / $1,995.26
| Professional | | $251.19 | $1,174.90 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $245.47
| Facility | | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $3,801.89
| Facility | | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $707.95 / $3,019.95
| Professional | | $316.23 | $707.95 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $15,135.61
| Facility | | $54.95 | $56.23 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12,022.64 / $12,022.64 / $13,803.84
| Professional | | $12,022.64 | $12,022.64 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $2,187.76 / $9,772.37
| Facility | | $331.13 | $2,187.76 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $1,479.11 / $2,454.71
| Professional | | $281.84 | $1,479.11 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $218.78
| Professional | | $32.36 | $33.11 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $977.24 / $5,011.87
| Professional | | $245.47 | $977.24 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $1,412.54 / $3,715.35
| Facility | | $302.00 | $1,412.54 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $676.08 / $3,019.95
| Professional | | $309.03 | $676.08 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $10,964.78
| Facility | | $1,698.24 | $5,248.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $1,122.02 / $2,818.38
| Professional | | $263.03 | $1,122.02 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,318.26 / $1,380.38
| Professional | | $1,318.26 | $1,318.26 | $1,380.38 |