- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,230.27 / $14,454.40
| Facility | | $660.69 | $1,230.27 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $660.69 / $1,230.27
| Professional | | $549.54 | $660.69 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,786.30 / $7,585.78
| Facility | | $3,311.31 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $1,122.02 / $2,951.21
| Professional | | $575.44 | $1,122.02 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $1,819.70 / $2,884.03
| Facility | | $1,548.82 | $1,819.70 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $630.96 / $1,318.26 / $2,511.89
| Professional | | $630.96 | $1,318.26 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $758.58 / $4,365.16
| Facility | | $562.34 | $758.58 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,318.26 / $1,949.84
| Professional | | $1,047.13 | $1,318.26 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $776.25 / $7,244.36
| Facility | | $575.44 | $776.25 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $1,023.29 / $4,466.84
| Professional | | $575.44 | $1,023.29 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $794.33 / $1,445.44 / $2,238.72
| Professional | | $794.33 | $1,445.44 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,943.28 / $7,943.28
| Facility | | $5,370.32 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $2,884.03 / $4,466.84
| Professional | | $602.56 | $2,884.03 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Professional | | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,187.76 / $3,019.95
| Professional | | $1,862.09 | $2,187.76 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $812.83 / $2,238.72
| Professional | | $549.54 | $812.83 | $2,238.72 |