- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $2,238.72 / $4,168.69
| Facility | | $234.42 | $2,238.72 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $239.88 / $616.60
| Professional | | $151.36 | $239.88 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $3,801.89
| Facility | | $56.23 | $1,258.93 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $309.03 / $776.25
| Professional | | $177.83 | $309.03 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $436.52
| Facility | | $190.55 | $190.55 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $371.54 / $691.83
| Professional | | $199.53 | $371.54 | $691.83 |
- 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
- $181.97 / $338.84 / $630.96
| Professional | | $181.97 | $338.84 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $245.47 / $7,079.46
| Facility | | $147.91 | $245.47 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $354.81 / $489.78
| Professional | | $288.40 | $354.81 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $316.23 / $645.65
| Professional | | $173.78 | $316.23 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $4,786.30 / $4,786.30
| Facility | | $4,786.30 | $4,786.30 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $1,258.93
| Professional | | $1,258.93 | $1,258.93 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $3,801.89
| Facility | | $56.23 | $1,258.93 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $309.03 / $776.25
| Professional | | $177.83 | $309.03 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $6,165.95
| Facility | | $954.99 | $2,344.23 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $316.23 / $660.69
| Professional | | $177.83 | $316.23 | $660.69 |