- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $1,548.82 / $6,606.93
| Facility | | $223.87 | $1,548.82 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $208.93 / $616.60
| Professional | | $117.49 | $208.93 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $114.82 / $245.47
| Professional | | $83.18 | $114.82 | $245.47 |
- 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
- $407.38 / $407.38 / $407.38
| Professional | | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $229.09 / $380.19
| Professional | | $147.91 | $229.09 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $229.09 / $407.38
| Professional | | $47.86 | $229.09 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $281.84 / $426.58
| Professional | | $173.78 | $281.84 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,096.48 / $1,778.28
| Facility | | $407.38 | $1,096.48 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $239.88 / $269.15
| Professional | | $190.55 | $239.88 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $1,348.96 / $6,165.95
| Facility | | $223.87 | $1,348.96 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $229.09 / $537.03
| Professional | | $138.04 | $229.09 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $213.80
| Professional | | $213.80 | $213.80 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $213.80 / $309.03
| Facility | | $144.54 | $213.80 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $213.80 / $354.81
| Professional | | $144.54 | $213.80 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $977.24 / $3,890.45
| Facility | | $223.87 | $977.24 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $218.78 / $371.54
| Professional | | $138.04 | $218.78 | $371.54 |