- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,187.76 / $6,918.31
| Facility | | $537.03 | $2,187.76 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $426.58 / $1,584.89
| Professional | | $177.83 | $426.58 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $407.38 / $575.44
| Professional | | $338.84 | $407.38 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $1,023.29 / $3,801.89
| Facility | | $204.17 | $1,023.29 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $302.00 / $512.86
| Professional | | $154.88 | $302.00 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $186.21 / $186.21
| Facility | | $186.21 | $186.21 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $407.38 / $645.65
| Professional | | $199.53 | $407.38 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $398.11 / $398.11
| Facility | | $151.36 | $398.11 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $389.05 / $630.96
| Professional | | $199.53 | $389.05 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $1,348.96
| Facility | | $54.95 | $56.23 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,951.21 / $3,467.37 / $3,467.37
| Professional | | $2,951.21 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $478.63 / $3,715.35
| Facility | | $169.82 | $478.63 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $389.05 / $870.96
| Professional | | $173.78 | $389.05 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $331.13
| Professional | | $32.36 | $33.11 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $346.74 / $575.44
| Facility | | $158.49 | $346.74 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $398.11 / $645.65
| Professional | | $204.17 | $398.11 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $1,047.13 / $2,691.53
| Facility | | $158.49 | $1,047.13 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $309.03 / $524.81
| Professional | | $169.82 | $309.03 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $389.05
| Professional | | $389.05 | $389.05 | $389.05 |