- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $346.74 / $3,630.78
| Facility | | $131.83 | $346.74 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $144.54 / $457.09
| Professional | | $83.18 | $144.54 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $512.86 / $2,951.21
| Facility | | $56.23 | $512.86 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $144.54 / $338.84
| Professional | | $79.43 | $144.54 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $93.33 / $213.80
| Facility | | $93.33 | $93.33 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $162.18 / $245.47
| Professional | | $93.33 | $162.18 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $162.18 / $275.42
| Professional | | $87.10 | $162.18 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $177.83 / $7,079.46
| Facility | | $74.13 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $147.91 / $213.80
| Professional | | $120.23 | $147.91 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $147.91 / $275.42
| Professional | | $87.10 | $147.91 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $239.88 / $575.44
| Facility | | $181.97 | $239.88 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $134.90 / $134.90
| Professional | | $134.90 | $134.90 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $512.86 / $2,951.21
| Facility | | $56.23 | $512.86 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $144.54 / $338.84
| Professional | | $81.28 | $144.54 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $147.91 / $281.84
| Professional | | $87.10 | $147.91 | $281.84 |