- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $1,819.70 / $3,890.45
| Facility | | $147.91 | $1,819.70 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $204.17 / $549.54
| Professional | | $104.71 | $204.17 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,949.84 / $13,489.63
| Facility | | $371.54 | $1,949.84 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $239.88 / $588.84
| Professional | | $144.54 | $239.88 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $416.87
| Facility | | $181.97 | $181.97 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $309.03 / $524.81
| Professional | | $181.97 | $309.03 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $257.04 / $537.03
| Professional | | $158.49 | $257.04 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $234.42 / $7,079.46
| Facility | | $138.04 | $234.42 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $269.15 / $389.05
| Professional | | $213.80 | $269.15 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $263.03 / $512.86
| Professional | | $162.18 | $263.03 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $954.99 / $2,238.72
| Facility | | $162.18 | $954.99 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $162.18 / $316.23
| Professional | | $141.25 | $162.18 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,949.84 / $13,489.63
| Facility | | $371.54 | $1,949.84 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $245.47 / $602.56
| Professional | | $144.54 | $245.47 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $6,165.95
| Facility | | $954.99 | $2,344.23 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $251.19 / $501.19
| Professional | | $151.36 | $251.19 | $501.19 |