- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,025.60 / $16,595.87
| Facility | | $1,698.24 | $6,025.60 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $457.09 / $1,479.11
| Professional | | $295.12 | $457.09 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $6,165.95 / $13,489.63
| Facility | | $3,630.78 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $407.38 / $851.14
| Professional | | $295.12 | $407.38 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $2,344.23 / $8,128.31
| Facility | | $66.07 | $2,344.23 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $457.09 / $891.25
| Professional | | $309.03 | $457.09 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $616.60 / $1,023.29
| Facility | | $407.38 | $616.60 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $457.09 / $891.25
| Professional | | $309.03 | $457.09 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $398.11 / $794.33
| Professional | | $213.80 | $398.11 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $537.03 / $912.01
| Professional | | $309.03 | $537.03 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $3,388.44
| Facility | | $54.95 | $56.23 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,388.44 / $3,981.07 / $3,981.07
| Professional | | $3,388.44 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $645.65
| Professional | | $389.05 | $389.05 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $478.63 / $812.83
| Facility | | $316.23 | $478.63 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $478.63 / $977.24
| Professional | | $302.00 | $478.63 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,513.56
| Professional | | $1,023.29 | $1,023.29 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $363.08 / $562.34
| Professional | | $269.15 | $363.08 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $7,244.36 / $15,135.61
| Facility | | $3,090.30 | $7,244.36 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $389.05 / $776.25
| Professional | | $257.04 | $389.05 | $776.25 |