- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $5,370.32 / $8,511.38
| Facility | | $346.74 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $346.74 / $724.44
| Professional | | $281.84 | $346.74 | $724.44 |
- 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
- $338.84 / $398.11 / $575.44
| Professional | | $338.84 | $398.11 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $524.81
| Facility | | $524.81 | $524.81 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $371.54 / $371.54 / $371.54
| Facility | 54 | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $371.54 / $630.96
| Professional | | $275.42 | $371.54 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $616.60 / $776.25
| Professional | | $457.09 | $616.60 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $446.68 / $645.65
| Professional | | $281.84 | $446.68 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $537.03 / $776.25
| Facility | | $537.03 | $537.03 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $346.74 / $354.81
| Professional | | $257.04 | $346.74 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $3,801.89 / $8,317.64
| Facility | | $346.74 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $446.68 / $870.96
| Professional | | $295.12 | $446.68 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $691.83
| Facility | | $398.11 | $398.11 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $489.78 / $724.44
| Professional | | $338.84 | $489.78 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $309.03 / $331.13
| Facility | | $72.44 | $309.03 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $302.00 / $331.13
| Professional | | $72.44 | $302.00 | $331.13 |
- 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
- $263.03 / $354.81 / $602.56
| Professional | | $263.03 | $354.81 | $602.56 |