- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,025.60 / $16,982.44
| Facility | | $1,698.24 | $6,025.60 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $380.19 / $1,584.89
| Professional | | $275.42 | $380.19 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $6,025.60 / $13,489.63
| Facility | | $3,548.13 | $6,025.60 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $549.54 / $1,096.48
| Professional | | $380.19 | $549.54 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $416.87 / $5,754.40
| Facility | | $66.07 | $416.87 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $512.86 / $1,023.29
| Professional | | $323.59 | $512.86 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $245.47
| Facility | | $204.17 | $204.17 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $436.52 / $831.76
| Professional | | $309.03 | $436.52 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $338.84 / $524.81
| Professional | | $281.84 | $338.84 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $398.11 / $660.69
| Professional | | $263.03 | $398.11 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $2,398.83
| Facility | | $54.95 | $56.23 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,691.53 / $3,311.31 / $3,311.31
| Professional | | $2,691.53 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $338.84 / $562.34
| Professional | | $338.84 | $338.84 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $457.09 / $707.95
| Facility | | $302.00 | $457.09 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $446.68 / $891.25
| Professional | | $309.03 | $446.68 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $977.24 / $977.24 / $1,230.27
| Professional | | $977.24 | $977.24 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $398.11 / $537.03
| Professional | | $257.04 | $398.11 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,584.89 / $6,456.54
| Facility | | $588.84 | $1,584.89 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $398.11 / $912.01
| Professional | | $269.15 | $398.11 | $912.01 |