- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $3,548.13 / $9,332.54
| Facility | | $436.52 | $3,548.13 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $407.38 / $851.14
| Professional | | $269.15 | $407.38 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,888.44 / $12,302.69
| Facility | | $3,388.44 | $5,888.44 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $416.87 / $1,047.13
| Professional | | $331.13 | $416.87 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $1,995.26 / $8,912.51
| Facility | | $389.05 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $602.56
| Professional | | $389.05 | $389.05 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $478.63 / $50,118.72
| Facility | | $478.63 | $478.63 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $537.03 / $1,380.38
| Professional | | $288.40 | $537.03 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $331.13 / $1,023.29
| Facility | | $263.03 | $331.13 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $660.69 / $933.25
| Professional | | $478.63 | $660.69 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $389.05
| Facility | | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $537.03 / $891.25
| Professional | | $346.74 | $537.03 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $50,118.72 / $75,857.76
| Facility | | $316.23 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $562.34 / $1,122.02
| Professional | | $398.11 | $562.34 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,365.16 / $9,549.93
| Facility | | $2,041.74 | $4,365.16 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $426.58 / $1,071.52
| Professional | | $263.03 | $426.58 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $338.84 / $1,380.38
| Facility | | $229.09 | $338.84 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $524.81 / $1,023.29
| Professional | | $338.84 | $524.81 | $1,023.29 |