- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,715.35 / $8,317.64
| Facility | | $660.69 | $3,715.35 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $416.87 / $812.83
| Professional | | $281.84 | $416.87 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $457.09 / $812.83
| Professional | | $436.52 | $457.09 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $524.81
| Facility | | $524.81 | $524.81 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $457.09 / $812.83
| Professional | | $302.00 | $457.09 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $724.44 / $912.01
| Professional | | $537.03 | $724.44 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $478.63 / $741.31
| Professional | | $281.84 | $478.63 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $354.81 / $457.09
| Professional | | $338.84 | $354.81 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,691.53 / $8,317.64
| Facility | | $676.08 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $489.78 / $1,122.02
| Professional | | $295.12 | $489.78 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $933.25 / $933.25
| Facility | | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $630.96 / $977.24
| Professional | | $489.78 | $630.96 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $436.52 / $467.74
| Facility | | $295.12 | $436.52 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $436.52 / $467.74
| Professional | | $295.12 | $436.52 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,162.28 / $5,754.40
| Facility | | $1,348.96 | $3,162.28 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $446.68 / $724.44
| Professional | | $295.12 | $446.68 | $724.44 |