- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $1,445.44 / $7,762.47
| Facility | | $114.82 | $1,445.44 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $177.83 / $436.52
| Professional | | $102.33 | $177.83 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $323.59 / $676.08
| Professional | | $162.18 | $323.59 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $537.03 / $851.14
| Facility | | $457.09 | $537.03 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $309.03 / $489.78
| Professional | | $141.25 | $309.03 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $323.59 / $3,311.31
| Facility | | $109.65 | $323.59 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $316.23 / $501.19
| Professional | | $218.78 | $316.23 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $323.59 / $5,248.07
| Facility | | $117.49 | $323.59 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $281.84 / $891.25
| Professional | | $147.91 | $281.84 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $338.84
| Professional | | $32.36 | $33.11 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $363.08 / $575.44
| Professional | | $223.87 | $363.08 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,659.59 / $1,659.59
| Facility | | $1,047.13 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $263.03 / $1,230.27
| Professional | | $141.25 | $263.03 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $512.86 / $741.31
| Professional | | $213.80 | $512.86 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,456.54
| Facility | | $2,884.03 | $3,801.89 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $213.80 / $562.34
| Professional | | $123.03 | $213.80 | $562.34 |