- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,691.53 / $8,317.64
| Facility | | $831.76 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $281.84 / $741.31
| Professional | | $239.88 | $281.84 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $269.15 / $489.78
| Professional | | $257.04 | $269.15 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $954.99 / $7,413.10
| Facility | | $436.52 | $954.99 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $323.59 / $549.54
| Professional | | $239.88 | $323.59 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Facility | | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $323.59 / $457.09
| Professional | | $239.88 | $323.59 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $295.12 / $407.38
| Professional | | $234.42 | $295.12 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,344.23 / $8,317.64
| Facility | | $660.69 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $363.08 / $891.25
| Professional | | $251.19 | $363.08 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $524.81
| Facility | | $524.81 | $524.81 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.98 / $426.58 / $645.65
| Professional | | $3.98 | $426.58 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $302.00 / $302.00
| Facility | | $251.19 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $257.04 / $407.38
| Professional | | $245.47 | $257.04 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $2,398.83 / $17,782.79
| Facility | | $549.54 | $2,398.83 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $288.40 / $467.74
| Professional | | $213.80 | $288.40 | $467.74 |