- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $3,630.78 / $8,317.64
| Facility | | $234.42 | $3,630.78 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $213.80 / $446.68
| Professional | | $147.91 | $213.80 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $6,760.83 / $7,413.10
| Facility | | $5,888.44 | $6,760.83 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $275.42 / $457.09
| Professional | | $181.97 | $275.42 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $204.17 / $5,495.41
| Professional | | $138.04 | $204.17 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $239.88 / $436.52
| Professional | | $162.18 | $239.88 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $309.03 / $371.54
| Professional | | $245.47 | $309.03 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $302.00 / $512.86
| Professional | | $245.47 | $302.00 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $239.88 / $389.05
| Facility | | $158.49 | $239.88 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $186.21 / $186.21
| Professional | | $186.21 | $186.21 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $204.17 / $7,413.10
| Facility | | $147.91 | $204.17 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $269.15 / $7,413.10
| Professional | | $194.98 | $269.15 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $9,549.93 / $19,054.61
| Facility | | $5,623.41 | $9,549.93 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $213.80 / $371.54
| Professional | | $131.83 | $213.80 | $371.54 |