- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,454.71 / $7,585.78
| Facility | | $537.03 | $2,454.71 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $363.08 / $602.56
| Professional | | $229.09 | $363.08 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $398.11 / $1,584.89
| Facility | | $239.88 | $398.11 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $371.54 / $524.81
| Professional | | $229.09 | $371.54 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $218.78 / $218.78
| Facility | | $79.43 | $218.78 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $426.58 / $724.44
| Professional | | $263.03 | $426.58 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $1,698.24
| Facility | | $54.95 | $56.23 | $1,698.24 |
- 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
- $251.19 / $489.78 / $2,951.21
| Facility | | $251.19 | $489.78 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $371.54 / $758.58
| Professional | | $234.42 | $371.54 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $194.98 / $346.74
| Professional | | $32.36 | $194.98 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $741.31
| Professional | | $371.54 | $371.54 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $416.87 / $741.31
| Facility | | $245.47 | $416.87 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $426.58 / $724.44
| Professional | | $257.04 | $426.58 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,786.30
| Facility | | $724.44 | $2,511.89 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $338.84 / $537.03
| Professional | | $218.78 | $338.84 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $436.52 / $436.52
| Professional | | $407.38 | $436.52 | $436.52 |