- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $1,778.28 / $7,244.36
| Facility | | $338.84 | $1,778.28 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $501.19 / $2,187.76
| Professional | | $181.97 | $501.19 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $380.19 / $691.83
| Professional | | $323.59 | $380.19 | $691.83 |
- 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
- $398.11 / $616.60 / $724.44
| Professional | | $398.11 | $616.60 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $371.54 / $616.60
| Professional | | $177.83 | $371.54 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.99 / $269.15 / $691.83
| Professional | | $23.99 | $269.15 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $489.78 / $741.31
| Professional | | $251.19 | $489.78 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $229.09 / $512.86
| Facility | | $134.90 | $229.09 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $398.11 / $436.52
| Professional | | $186.21 | $398.11 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.83 / $1,513.56 / $1,513.56
| Professional | | $691.83 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,584.89 / $7,244.36
| Facility | | $354.81 | $1,584.89 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $416.87 / $1,148.15
| Professional | | $173.78 | $416.87 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $257.04
| Professional | | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $371.54 / $398.11
| Facility | | $186.21 | $371.54 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $398.11 / $416.87
| Professional | | $186.21 | $398.11 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $645.65 / $4,265.80
| Facility | | $144.54 | $645.65 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $338.84 / $562.34
| Professional | | $173.78 | $338.84 | $562.34 |