- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $6,918.31 / $15,848.93
| Facility | | $588.84 | $6,918.31 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $371.54 / $1,348.96
| Professional | | $269.15 | $371.54 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $12,589.25
| Facility | | $5,011.87 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $537.03 / $1,380.38
| Professional | | $281.84 | $537.03 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $851.14 / $1,348.96
| Facility | | $724.44 | $851.14 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $912.01 / $1,023.29
| Professional | | $426.58 | $912.01 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $3,801.89 / $7,413.10
| Facility | | $309.03 | $3,801.89 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $707.95 / $870.96
| Professional | | $501.19 | $707.95 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $5,495.41 / $8,709.64
| Facility | | $309.03 | $5,495.41 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $512.86 / $3,467.37
| Professional | | $288.40 | $512.86 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $389.05
| Professional | | $32.36 | $33.11 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $645.65 / $1,096.48
| Professional | | $331.13 | $645.65 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,332.54 / $9,332.54
| Facility | | $6,309.57 | $9,332.54 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $1,412.54 / $3,467.37
| Professional | | $389.05 | $1,412.54 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,659.59 / $2,089.30
| Professional | | $1,202.26 | $1,659.59 | $2,089.30 |
- 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
- $281.84 / $467.74 / $1,230.27
| Professional | | $281.84 | $467.74 | $1,230.27 |