- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,023.29 / $14,454.40
| Facility | | $524.81 | $1,023.29 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $549.54 / $1,230.27
| Professional | | $457.09 | $549.54 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,317.64 / $13,182.57
| Facility | | $5,011.87 | $8,317.64 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $933.25 / $2,187.76
| Professional | | $478.63 | $933.25 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,479.11 / $2,398.83
| Facility | | $1,288.25 | $1,479.11 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $1,584.89 / $1,778.28
| Professional | | $707.95 | $1,584.89 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $4,677.35 / $8,912.51
| Facility | | $537.03 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,230.27 / $1,513.56
| Professional | | $870.96 | $1,230.27 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $6,918.31 / $12,302.69
| Facility | | $537.03 | $6,918.31 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $870.96 / $4,168.69
| Professional | | $489.78 | $870.96 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $660.69
| Professional | | $32.36 | $33.11 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $1,148.15 / $1,584.89
| Professional | | $588.84 | $1,148.15 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $9,549.93 / $9,549.93
| Facility | | $6,456.54 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $2,398.83 / $4,168.69
| Professional | | $676.08 | $2,398.83 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,348.96 / $1,348.96
| Professional | | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,398.83 / $2,398.83
| Professional | | $1,412.54 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $12,589.25
| Facility | | $6,606.93 | $10,232.93 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $794.33 / $2,137.96
| Professional | | $467.74 | $794.33 | $2,137.96 |