- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,691.53 / $8,317.64
| Facility | | $588.84 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $131.83 / $354.81
| Professional | | $83.18 | $131.83 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- 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
- $109.65 / $169.82 / $257.04
| Professional | | $109.65 | $169.82 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $147.91 / $154.88
| Professional | | $138.04 | $147.91 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,344.23 / $8,317.64
| Facility | | $537.03 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $138.04 / $346.74
| Professional | | $85.11 | $138.04 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $128.82 / $128.82
| Professional | | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $93.33 / $144.54
| Facility | | $74.13 | $93.33 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $93.33 / $467.74
| Professional | | $63.10 | $93.33 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $616.60 / $3,890.45
| Facility | | $223.87 | $616.60 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $131.83 / $223.87
| Professional | | $83.18 | $131.83 | $223.87 |