- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $2,238.72 / $3,801.89
| Facility | | $158.49 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $177.83 / $363.08
| Professional | | $112.20 | $177.83 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $758.58 / $2,818.38
| Facility | | $56.23 | $758.58 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $239.88 / $602.56
| Professional | | $131.83 | $239.88 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $354.81
| Facility | | $154.88 | $154.88 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $354.81 / $575.44
| Professional | | $177.83 | $354.81 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $251.19 / $512.86
| Professional | | $147.91 | $251.19 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $501.19 / $7,079.46
| Facility | | $112.20 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $281.84 / $398.11
| Professional | | $213.80 | $281.84 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $245.47 / $512.86
| Professional | | $131.83 | $245.47 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $758.58 / $2,818.38
| Facility | | $56.23 | $758.58 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $239.88 / $616.60
| Professional | | $131.83 | $239.88 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,819.70 / $2,818.38
| Facility | | $575.44 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $245.47 / $467.74
| Professional | | $131.83 | $245.47 | $467.74 |