- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,884.03 / $5,128.61
| Facility | | $467.74 | $2,884.03 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $489.78 / $1,318.26
| Professional | | $309.03 | $489.78 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $3,981.07 / $45,708.82
| Facility | | $758.58 | $3,981.07 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $575.44 / $3,467.37
| Professional | | $323.59 | $575.44 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $870.96
| Facility | | $380.19 | $380.19 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $851.14 / $1,318.26
| Professional | | $562.34 | $851.14 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $3,090.30
| Facility | | $676.08 | $741.31 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $549.54 / $1,202.26
| Professional | | $316.23 | $549.54 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $707.95 / $7,079.46
| Facility | | $323.59 | $707.95 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $794.33 / $1,096.48
| Professional | | $575.44 | $794.33 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $3,801.89 / $9,772.37
| Facility | | $524.81 | $3,801.89 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $676.08 / $1,380.38
| Professional | | $389.05 | $676.08 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $4,466.84 / $4,466.84
| Facility | | $1,584.89 | $4,466.84 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $3,981.07 / $45,708.82
| Facility | | $758.58 | $3,981.07 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $575.44 / $3,467.37
| Professional | | $323.59 | $575.44 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,890.45 / $9,120.11
| Facility | | $1,071.52 | $3,890.45 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $602.56 / $1,348.96
| Professional | | $331.13 | $602.56 | $1,348.96 |