- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,370.32 / $8,511.38
| Facility | | $1,023.29 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $467.74 / $870.96
| Professional | | $380.19 | $467.74 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $457.09 / $812.83
| Professional | | $446.68 | $457.09 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $676.08 / $676.08
| Facility | | $676.08 | $676.08 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $457.09 / $741.31
| Professional | | $338.84 | $457.09 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $562.34 / $776.25
| Professional | | $562.34 | $562.34 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $467.74 / $776.25
| Professional | | $371.54 | $467.74 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,570.88 / $8,511.38
| Facility | | $1,023.29 | $4,570.88 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $501.19 / $1,288.25
| Professional | | $389.05 | $501.19 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $870.96
| Professional | | $467.74 | $467.74 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $389.05 / $436.52
| Facility | | $316.23 | $389.05 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $389.05 / $575.44
| Professional | | $316.23 | $389.05 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,570.40 / $4,265.80
| Facility | | $912.01 | $2,570.40 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $457.09 / $794.33
| Professional | | $338.84 | $457.09 | $794.33 |