- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $407.38 / $933.25
| Professional | | $295.12 | $407.38 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $398.11 / $398.11
| Professional | | $338.84 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $501.19 / $776.25
| Facility | | $346.74 | $501.19 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $426.58 / $741.31
| Professional | | $302.00 | $426.58 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Facility | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $588.84 / $831.76
| Professional | | $436.52 | $588.84 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $426.58 / $707.95
| Professional | | $323.59 | $426.58 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,344.23 / $8,317.64
| Facility | | $616.60 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $478.63 / $1,174.90
| Professional | | $309.03 | $478.63 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $346.74 / $831.76
| Facility | | $323.59 | $346.74 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $776.25 / $1,023.29
| Professional | | $346.74 | $776.25 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $309.03 / $389.05
| Facility | | $288.40 | $309.03 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $309.03 / $389.05
| Professional | | $281.84 | $309.03 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $676.08 / $3,019.95
| Facility | | $85.11 | $676.08 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $389.05 / $645.65
| Professional | | $275.42 | $389.05 | $645.65 |