- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $2,630.27 / $8,317.64
| Facility | | $354.81 | $2,630.27 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $331.13 / $812.83
| Professional | | $138.04 | $331.13 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $302.00 / $478.63
| Professional | | $173.78 | $302.00 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $57,543.99
| Facility | | $3,801.89 | $3,801.89 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $218.78 / $562.34
| Professional | | $204.17 | $218.78 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $245.47
| Facility | | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $316.23 / $676.08
| Professional | | $144.54 | $316.23 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $616.60 / $758.58
| Professional | | $446.68 | $616.60 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $446.68 / $724.44
| Professional | | $147.91 | $446.68 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,630.78 / $7,079.46
| Facility | | $2,398.83 | $3,630.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $331.13 / $426.58
| Professional | | $154.88 | $331.13 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $2,344.23 / $7,762.47
| Facility | | $380.19 | $2,344.23 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $346.74 / $870.96
| Professional | | $144.54 | $346.74 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $776.25
| Facility | | $234.42 | $234.42 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $302.00 / $831.76
| Professional | | $281.84 | $302.00 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $309.03 / $389.05
| Facility | | $141.25 | $309.03 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $309.03 / $575.44
| Professional | | $141.25 | $309.03 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,691.53 / $5,888.44
| Facility | | $912.01 | $2,691.53 | $5,888.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $295.12 / $588.84
| Professional | | $141.25 | $295.12 | $588.84 |