- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $3,630.78 / $10,964.78
| Facility | | $512.86 | $3,630.78 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $446.68 / $1,122.02
| Professional | | $331.13 | $446.68 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,762.47 / $13,803.84
| Facility | | $4,073.80 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $407.38 / $977.24
| Professional | | $323.59 | $407.38 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $37,153.52
| Facility | | $588.84 | $588.84 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $588.84
| Professional | | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $707.95 / $50,118.72
| Facility | | $34.67 | $707.95 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $676.08 / $1,862.09
| Professional | | $416.87 | $676.08 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $1,584.89 / $3,388.44
| Facility | | $457.09 | $1,584.89 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $575.44 / $812.83
| Professional | | $457.09 | $575.44 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $501.19 / $1,047.13
| Professional | | $309.03 | $501.19 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $50,118.72 / $75,857.76
| Facility | | $3,235.94 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $562.34 / $870.96
| Professional | | $398.11 | $562.34 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,677.35 / $25,703.96
| Facility | | $2,089.30 | $4,677.35 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $501.19 / $1,174.90
| Professional | | $363.08 | $501.19 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $446.68 / $1,122.02
| Facility | | $338.84 | $446.68 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $501.19 / $1,318.26
| Professional | | $309.03 | $501.19 | $1,318.26 |