- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $2,238.72 / $5,128.61
| Facility | | $125.89 | $2,238.72 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $190.55 / $436.52
| Professional | | $102.33 | $190.55 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,949.84 / $4,786.30
| Facility | | $56.23 | $1,949.84 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $199.53 / $501.19
| Professional | | $117.49 | $199.53 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $141.25 / $323.59
| Facility | | $141.25 | $141.25 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $245.47 / $446.68
| Professional | | $141.25 | $245.47 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $245.47 / $446.68
| Professional | | $138.04 | $245.47 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $218.78 / $7,079.46
| Facility | | $117.49 | $218.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $239.88 / $346.74
| Professional | | $186.21 | $239.88 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $229.09 / $457.09
| Professional | | $141.25 | $229.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,819.70 / $16,595.87
| Facility | | $1,258.93 | $1,819.70 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,949.84 / $4,786.30
| Facility | | $56.23 | $1,949.84 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $199.53 / $512.86
| Professional | | $117.49 | $199.53 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $208.93 / $416.87
| Professional | | $125.89 | $208.93 | $416.87 |