- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $489.78 / $9,332.54
| Facility | | $199.53 | $489.78 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $229.09 / $660.69
| Professional | | $147.91 | $229.09 | $660.69 |
- 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
- $223.87 / $446.68 / $977.24
| Professional | | $223.87 | $446.68 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $741.31 / $1,174.90
| Facility | | $630.96 | $741.31 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $398.11 / $660.69
| Professional | | $208.93 | $398.11 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $489.78 / $3,715.35
| Facility | | $173.78 | $489.78 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $489.78 / $707.95
| Professional | | $331.13 | $489.78 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $457.09 / $5,128.61
| Facility | | $190.55 | $457.09 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $398.11 / $1,348.96
| Professional | | $218.78 | $398.11 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $512.86
| Professional | | $32.36 | $33.11 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $524.81 / $794.33
| Professional | | $323.59 | $524.81 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,981.07 / $3,981.07
| Facility | | $2,754.23 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $323.59 / $1,737.80
| Professional | | $181.97 | $323.59 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $776.25 / $1,023.29
| Professional | | $371.54 | $776.25 | $1,023.29 |
- 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
- $186.21 / $316.23 / $794.33
| Professional | | $186.21 | $316.23 | $794.33 |