- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,128.61 / $8,511.38
| Facility | | $977.24 | $5,128.61 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $478.63 / $1,348.96
| Professional | | $363.08 | $478.63 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $426.58 / $724.44
| Professional | | $407.38 | $426.58 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $2,089.30 / $4,786.30
| Facility | | $645.65 | $2,089.30 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $467.74 / $831.76
| Professional | | $346.74 | $467.74 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $912.01
| Facility | | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $588.84 / $812.83
| Professional | | $436.52 | $588.84 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $436.52 / $707.95
| Professional | | $363.08 | $436.52 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.50 / $8,709.64 / $43,651.58
| Facility | | $0.50 | $8,709.64 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $4,786.30 / $8,511.38
| Facility | | $977.24 | $4,786.30 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $602.56 / $1,348.96
| Professional | | $371.54 | $602.56 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $549.54 / $831.76
| Facility | | $457.09 | $549.54 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $707.95 / $851.14
| Professional | | $457.09 | $707.95 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $467.74 / $912.01
| Facility | | $398.11 | $467.74 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $467.74 / $912.01
| Professional | | $398.11 | $467.74 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $3,630.78 / $10,471.29
| Facility | | $1,258.93 | $3,630.78 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $436.52 / $724.44
| Professional | | $338.84 | $436.52 | $724.44 |