- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $6,165.95 / $9,549.93
| Facility | | $1,288.25 | $6,165.95 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,778.28 / $4,073.80
| Professional | | $1,479.11 | $1,778.28 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $21,379.62 / $57,543.99
| Facility | | $20,417.38 | $21,379.62 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,511.89 / $2,511.89
| Professional | | $2,344.23 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $794.33 / $2,818.38
| Facility | | $501.19 | $794.33 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,862.09 / $3,467.37
| Professional | | $1,230.27 | $1,862.09 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $3,548.13
| Facility | | $3,548.13 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,290.87 / $3,162.28
| Professional | | $1,698.24 | $2,290.87 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,698.24 / $2,754.23
| Professional | | $1,479.11 | $1,698.24 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $46,773.51 / $46,773.51
| Facility | | $46,773.51 | $46,773.51 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,786.30 / $8,709.64
| Facility | | $1,023.29 | $4,786.30 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,137.96 / $4,786.30
| Professional | | $1,479.11 | $2,137.96 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,737.80 / $3,311.31
| Facility | | $1,479.11 | $1,737.80 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,691.53 / $3,467.37
| Professional | | $1,479.11 | $2,691.53 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,698.24 / $1,698.24
| Facility | | $1,621.81 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,621.81 / $1,659.59 / $1,698.24
| Professional | | $1,621.81 | $1,659.59 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $2,089.30 / $6,309.57
| Facility | | $316.23 | $2,089.30 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,778.28 / $2,884.03
| Professional | | $1,348.96 | $1,778.28 | $2,884.03 |