- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $7,585.78 / $18,197.01
| Facility | | $3,019.95 | $7,585.78 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $281.84 / $1,380.38
| Professional | | $223.87 | $281.84 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,943.28 / $15,848.93
| Facility | | $4,570.88 | $7,943.28 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $416.87 / $812.83
| Professional | | $302.00 | $416.87 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $3,090.30 / $8,709.64
| Facility | | $66.07 | $3,090.30 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $389.05 / $758.58
| Professional | | $269.15 | $389.05 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,137.96 / $2,137.96
| Facility | | $2,137.96 | $2,137.96 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $316.23 / $660.69
| Professional | | $251.19 | $316.23 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $562.34 / $831.76
| Professional | | $257.04 | $562.34 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $281.84 / $524.81
| Professional | | $223.87 | $281.84 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $9,549.93
| Facility | | $54.95 | $56.23 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Professional | | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $371.54
| Professional | | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $338.84 / $616.60
| Facility | | $245.47 | $338.84 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $323.59 / $660.69
| Professional | | $251.19 | $323.59 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $812.83
| Professional | | $812.83 | $812.83 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $562.34 / $954.99
| Professional | | $208.93 | $562.34 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $7,585.78 / $15,135.61
| Facility | | $3,981.07 | $7,585.78 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $281.84 / $724.44
| Professional | | $199.53 | $281.84 | $724.44 |