- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,890.45 / $8,317.64
| Facility | | $1,047.13 | $3,890.45 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $181.97 / $512.86
| Professional | | $154.88 | $181.97 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $269.15 / $275.42
| Professional | | $257.04 | $269.15 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $302.00
| Facility | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $223.87 / $363.08
| Professional | | $158.49 | $223.87 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $245.47 / $316.23
| Professional | | $181.97 | $245.47 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $208.93 / $323.59
| Professional | | $151.36 | $208.93 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Professional | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,691.53 / $8,317.64
| Facility | | $954.99 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $234.42 / $602.56
| Professional | | $162.18 | $234.42 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $281.84 / $363.08
| Facility | | $281.84 | $281.84 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $245.47 / $331.13
| Professional | | $234.42 | $245.47 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $181.97 / $416.87
| Facility | | $128.82 | $181.97 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $407.38 / $416.87
| Professional | | $169.82 | $407.38 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $645.65 / $4,265.80
| Facility | | $144.54 | $645.65 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $223.87 / $346.74
| Professional | | $151.36 | $223.87 | $346.74 |