- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,691.53 / $8,317.64
| Facility | | $537.03 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $131.83 / $371.54
| Professional | | $81.28 | $131.83 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $131.83 / $151.36
| Professional | | $104.71 | $131.83 | $151.36 |
- 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
- $257.04 / $257.04 / $257.04
| Professional | | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $141.25 / $229.09
| Professional | | $89.13 | $141.25 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $229.09 / $251.19
| Professional | | $177.83 | $229.09 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $181.97 / $269.15
| Professional | | $117.49 | $181.97 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $1,479.11
| Facility | | $758.58 | $758.58 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,344.23 / $7,762.47
| Facility | | $537.03 | $2,344.23 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $147.91 / $371.54
| Professional | | $83.18 | $147.91 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Professional | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $141.25 / $186.21
| Facility | | $69.18 | $141.25 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $141.25 / $194.98
| Professional | | $69.18 | $141.25 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,584.89 / $3,890.45
| Facility | | $467.74 | $1,584.89 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $131.83 / $229.09
| Professional | | $85.11 | $131.83 | $229.09 |