- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $309.03 / $537.03
| Professional | | $158.49 | $309.03 | $537.03 |
- 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
- $316.23 / $323.59 / $575.44
| Professional | | $316.23 | $323.59 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $776.25 / $776.25
| Facility | | $776.25 | $776.25 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $288.40 / $501.19
| Professional | | $151.36 | $288.40 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $562.34
| Professional | | $407.38 | $407.38 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $338.84 / $549.54
| Professional | | $181.97 | $338.84 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $380.19
| Professional | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,344.23 / $8,317.64
| Facility | | $616.60 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $323.59 / $812.83
| Professional | | $162.18 | $323.59 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $630.96
| Professional | | $407.38 | $407.38 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $158.49 / $501.19
| Facility | | $70.79 | $158.49 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $162.18 / $346.74
| Professional | | $158.49 | $162.18 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,238.72 / $7,413.10
| Facility | | $501.19 | $2,238.72 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $281.84 / $489.78
| Professional | | $147.91 | $281.84 | $489.78 |