- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,691.53 / $8,317.64
| Facility | | $660.69 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $199.53 / $416.87
| Professional | | $165.96 | $199.53 | $416.87 |
- 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
- $181.97 / $269.15 / $295.12
| Professional | | $181.97 | $269.15 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $323.59
| Facility | | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $218.78 / $389.05
| Professional | | $162.18 | $218.78 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $346.74 / $436.52
| Professional | | $257.04 | $346.74 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $263.03 / $380.19
| Professional | | $162.18 | $263.03 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $234.42
| Professional | | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,344.23 / $8,317.64
| Facility | | $588.84 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $251.19 / $588.84
| Professional | | $173.78 | $251.19 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $398.11
| Facility | | $204.17 | $204.17 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $263.03 / $416.87
| Professional | | $204.17 | $263.03 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.51 / $141.25 / $186.21
| Facility | | $29.51 | $141.25 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.51 / $181.97 / $208.93
| Professional | | $29.51 | $181.97 | $208.93 |
- 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
- $154.88 / $208.93 / $354.81
| Professional | | $154.88 | $208.93 | $354.81 |