- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $1,584.89 / $6,165.95
| Facility | | $144.54 | $1,584.89 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $158.49 / $501.19
| Professional | | $75.86 | $158.49 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $104.71 / $173.78
| Professional | | $61.66 | $104.71 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $186.21 / $186.21
| Professional | | $186.21 | $186.21 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $147.91 / $239.88
| Professional | | $95.50 | $147.91 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.99 / $154.88 / $263.03
| Professional | | $23.99 | $154.88 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $177.83 / $275.42
| Professional | | $120.23 | $177.83 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $912.01 / $1,862.09
| Facility | | $524.81 | $912.01 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $151.36 / $173.78
| Professional | | $131.83 | $151.36 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $1,348.96 / $5,370.32
| Facility | | $144.54 | $1,348.96 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $154.88 / $380.19
| Professional | | $89.13 | $154.88 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $154.88
| Professional | | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $125.89 / $309.03
| Facility | | $91.20 | $125.89 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $151.36 / $407.38
| Professional | | $91.20 | $151.36 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $912.01 / $3,890.45
| Facility | | $223.87 | $912.01 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $134.90 / $239.88
| Professional | | $89.13 | $134.90 | $239.88 |