- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $2,511.89 / $3,715.35
| Facility | | $251.19 | $2,511.89 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $354.81 / $891.25
| Professional | | $234.42 | $354.81 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $5,011.87 / $28,840.32
| Facility | | $660.69 | $5,011.87 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $416.87 / $954.99
| Professional | | $251.19 | $416.87 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $316.23 / $724.44
| Facility | | $316.23 | $316.23 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $588.84 / $891.25
| Professional | | $363.08 | $588.84 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $436.52 / $912.01
| Professional | | $288.40 | $436.52 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $524.81 / $7,079.46
| Facility | | $251.19 | $524.81 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $457.09 / $660.69
| Professional | | $354.81 | $457.09 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $478.63 / $891.25
| Professional | | $295.12 | $478.63 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,786.30 / $10,964.78
| Facility | | $2,884.03 | $4,786.30 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $512.86 / $524.81
| Professional | | $478.63 | $512.86 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $5,011.87 / $28,840.32
| Facility | | $660.69 | $5,011.87 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $426.58 / $977.24
| Professional | | $251.19 | $426.58 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,549.93
| Facility | | $1,862.09 | $4,265.80 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $436.52 / $870.96
| Professional | | $275.42 | $436.52 | $870.96 |