- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,691.53 / $8,317.64
| Facility | | $537.03 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $114.82 / $316.23
| Professional | | $72.44 | $114.82 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $147.91 / $194.98
| Professional | | $114.82 | $147.91 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $131.83 / $131.83
| Facility | | $131.83 | $131.83 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $117.49 / $204.17
| Professional | | $79.43 | $117.49 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $204.17 / $257.04
| Professional | | $147.91 | $204.17 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $131.83 / $204.17
| Professional | | $70.79 | $131.83 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $120.23 / $138.04
| Professional | | $104.71 | $120.23 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,344.23 / $7,762.47
| Facility | | $588.84 | $2,344.23 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $128.82 / $288.40
| Professional | | $75.86 | $128.82 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $112.20 / $245.47
| Facility | | $112.20 | $112.20 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $190.55 / $263.03
| Professional | | $112.20 | $190.55 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $66.07 / $114.82
| Facility | | $51.29 | $66.07 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.44 / $74.13 / $123.03
| Professional | | $23.44 | $74.13 | $123.03 |
- 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
- $74.13 / $107.15 / $177.83
| Professional | | $74.13 | $107.15 | $177.83 |