- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $5,754.40 / $14,125.38
| Facility | | $354.81 | $5,754.40 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $288.40 / $630.96
| Professional | | $134.90 | $288.40 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,897.79 / $7,585.78
| Facility | | $3,311.31 | $4,897.79 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $398.11 / $1,122.02
| Professional | | $186.21 | $398.11 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $977.24 / $1,584.89
| Facility | | $851.14 | $977.24 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $457.09 / $1,258.93
| Professional | | $169.82 | $457.09 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $269.15 / $2,238.72
| Facility | | $131.83 | $269.15 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $446.68 / $851.14
| Professional | | $251.19 | $446.68 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $275.42 / $5,623.41
| Facility | | $131.83 | $275.42 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $645.65 / $2,290.87
| Professional | | $257.04 | $645.65 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $173.78
| Professional | | $32.36 | $33.11 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $489.78 / $1,122.02
| Professional | | $239.88 | $489.78 | $1,122.02 |
- 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
- $169.82 / $676.08 / $2,238.72
| Professional | | $169.82 | $676.08 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $741.31 / $1,584.89
| Professional | | $436.52 | $741.31 | $1,584.89 |
- 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
- $141.25 / $288.40 / $758.58
| Professional | | $141.25 | $288.40 | $758.58 |