- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $6,606.93 / $11,220.18
| Facility | | $1,288.25 | $6,606.93 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $346.74 / $741.31
| Professional | | $208.93 | $346.74 | $741.31 |
- 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
- $309.03 / $331.13 / $331.13
| Professional | | $309.03 | $331.13 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,096.48 / $3,630.78
| Facility | | $371.54 | $1,096.48 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $323.59 / $575.44
| Professional | | $208.93 | $323.59 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $537.03 / $758.58
| Professional | | $389.05 | $537.03 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $363.08 / $602.56
| Professional | | $223.87 | $363.08 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,370.32 / $10,964.78
| Facility | | $1,023.29 | $5,370.32 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $398.11 / $1,047.13
| Professional | | $213.80 | $398.11 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $812.83
| Facility | | $269.15 | $269.15 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $630.96 / $776.25
| Professional | | $269.15 | $630.96 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $204.17 / $363.08
| Facility | | $70.79 | $204.17 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $213.80 / $416.87
| Professional | | $70.79 | $213.80 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $2,951.21 / $9,549.93
| Facility | | $851.14 | $2,951.21 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $295.12 / $501.19
| Professional | | $186.21 | $295.12 | $501.19 |