- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $2,344.23 / $7,762.47
| Facility | | $407.38 | $2,344.23 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $302.00 / $616.60
| Professional | | $234.42 | $302.00 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $380.19 / $501.19
| Professional | | $295.12 | $380.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $316.23 / $316.23 / $316.23
| Facility | 54 | $316.23 | $316.23 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $316.23 / $524.81
| Professional | | $234.42 | $316.23 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $537.03 / $676.08
| Professional | | $389.05 | $537.03 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $380.19 / $537.03
| Professional | | $234.42 | $380.19 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,380.38 / $1,380.38
| Facility | | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $331.13 / $389.05
| Professional | | $302.00 | $331.13 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,584.89 / $7,244.36
| Facility | | $407.38 | $1,584.89 | $7,244.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $363.08 / $758.58
| Professional | | $245.47 | $363.08 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $602.56
| Facility | | $346.74 | $346.74 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $416.87 / $630.96
| Professional | | $288.40 | $416.87 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $245.47 / $309.03
| Facility | | $32.36 | $245.47 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $257.04 / $309.03
| Professional | | $32.36 | $257.04 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $676.08 / $3,890.45
| Facility | | $223.87 | $676.08 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $295.12 / $501.19
| Professional | | $218.78 | $295.12 | $501.19 |