- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $10,000.00 / $11,220.18
| Facility | | $3,388.44 | $10,000.00 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $524.81 / $1,096.48
| Professional | | $363.08 | $524.81 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $3,981.07 / $8,912.51
| Facility | | $2,187.76 | $3,981.07 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $776.25 / $812.83
| Professional | | $660.69 | $776.25 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $602.56 / $851.14
| Professional | | $398.11 | $602.56 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $630.96 / $1,202.26
| Facility | | $407.38 | $630.96 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $707.95 / $831.76
| Professional | | $416.87 | $707.95 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $7,762.47 / $12,302.69
| Facility | | $6,165.95 | $7,762.47 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $794.33 / $870.96
| Professional | | $602.56 | $794.33 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $398.11 / $7,244.36
| Professional | | $363.08 | $398.11 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,982.44 / $18,197.01
| Facility | | $9,332.54 | $16,982.44 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $562.34 / $831.76
| Professional | | $407.38 | $562.34 | $831.76 |