- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,818.38 / $8,317.64
| Facility | | $660.69 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $234.42 / $501.19
| Professional | | $147.91 | $234.42 | $501.19 |
- 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
- $229.09 / $380.19 / $457.09
| Professional | | $229.09 | $380.19 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Facility | | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $251.19 / $436.52
| Professional | | $158.49 | $251.19 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $407.38 / $512.86
| Professional | | $295.12 | $407.38 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $275.42 / $416.87
| Professional | | $154.88 | $275.42 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $1,445.44
| Facility | | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,344.23 / $8,317.64
| Facility | | $588.84 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $269.15 / $707.95
| Professional | | $158.49 | $269.15 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $524.81
| Facility | | $229.09 | $229.09 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $288.40 / $524.81
| Professional | | $269.15 | $288.40 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $245.47 / $467.74
| Facility | | $158.49 | $245.47 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $257.04 / $467.74
| Professional | | $154.88 | $257.04 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,584.89 / $3,890.45
| Facility | | $501.19 | $1,584.89 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $239.88 / $389.05
| Professional | | $151.36 | $239.88 | $389.05 |