- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $389.05 / $776.25
| Professional | | $331.13 | $389.05 | $776.25 |
- 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
- $398.11 / $416.87 / $691.83
| Professional | | $398.11 | $416.87 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $616.60 / $616.60
| Facility | | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $436.52 / $741.31
| Professional | | $316.23 | $436.52 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.81 / $707.95 / $891.25
| Professional | | $524.81 | $707.95 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $512.86 / $758.58
| Professional | | $323.59 | $512.86 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $380.19
| Professional | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,344.23 / $7,762.47
| Facility | | $616.60 | $2,344.23 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $501.19 / $1,148.15
| Professional | | $346.74 | $501.19 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $489.78 / $831.76
| Facility | | $489.78 | $489.78 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $489.78 / $831.76
| Professional | | $389.05 | $489.78 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $331.13 / $389.05
| Facility | | $309.03 | $331.13 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $354.81 / $416.87
| Professional | | $309.03 | $354.81 | $416.87 |
- 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
- $302.00 / $416.87 / $707.95
| Professional | | $302.00 | $416.87 | $707.95 |