- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,235.94 / $5,623.41
| Facility | | $1,023.29 | $3,235.94 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $660.69 / $1,513.56
| Professional | | $218.78 | $660.69 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $5,128.61
| Facility | | $56.23 | $1,258.93 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $5,248.07 / $5,248.07 / $5,248.07
| Facility | 52 | $5,248.07 | $5,248.07 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $691.83 / $2,187.76
| Professional | | $234.42 | $691.83 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $602.56
| Facility | | $257.04 | $257.04 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $676.08 / $1,548.82
| Professional | | $257.04 | $676.08 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $2,570.40
| Facility | | $676.08 | $741.31 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $575.44 / $1,659.59
| Professional | | $251.19 | $575.44 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $575.44 / $7,079.46
| Facility | | $204.17 | $575.44 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,230.27 / $1,737.80
| Professional | | $870.96 | $1,230.27 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $794.33 / $2,041.74
| Professional | | $239.88 | $794.33 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,818.38 / $3,162.28
| Facility | | $1,819.70 | $2,818.38 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $5,128.61
| Facility | | $56.23 | $1,258.93 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $5,248.07 / $5,248.07 / $5,248.07
| Facility | 52 | $5,248.07 | $5,248.07 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $691.83 / $2,238.72
| Professional | | $239.88 | $691.83 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,467.37 / $8,511.38
| Facility | | $812.83 | $3,467.37 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $660.69 / $1,862.09
| Professional | | $239.88 | $660.69 | $1,862.09 |