- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $2,691.53 / $4,897.79
| Facility | | $245.47 | $2,691.53 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $295.12 / $794.33
| Professional | | $190.55 | $295.12 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,511.89 / $13,489.63
| Facility | | $537.03 | $2,511.89 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $389.05 / $912.01
| Professional | | $234.42 | $389.05 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $616.60
| Facility | | $269.15 | $269.15 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $575.44 / $851.14
| Professional | | $346.74 | $575.44 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $398.11 / $851.14
| Professional | | $251.19 | $398.11 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $316.23 / $7,079.46
| Facility | | $177.83 | $316.23 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $426.58 / $616.60
| Professional | | $331.13 | $426.58 | $616.60 |
- 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
- $234.42 / $389.05 / $812.83
| Professional | | $234.42 | $389.05 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $776.25 / $3,548.13
| Facility | | $162.18 | $776.25 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Professional | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $2,511.89 / $13,489.63
| Facility | | $549.54 | $2,511.89 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $389.05 / $933.25
| Professional | | $234.42 | $389.05 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,511.89 / $6,165.95
| Facility | | $1,047.13 | $2,511.89 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $398.11 / $776.25
| Professional | | $234.42 | $398.11 | $776.25 |