- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,890.45 / $8,317.64
| Facility | | $954.99 | $3,890.45 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $537.03 / $1,047.13
| Professional | | $323.59 | $537.03 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $588.84 / $1,047.13
| Professional | | $575.44 | $588.84 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $524.81 / $1,023.29
| Professional | | $323.59 | $524.81 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $758.58 / $1,047.13 / $1,318.26
| Professional | | $758.58 | $1,047.13 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $630.96 / $1,023.29
| Professional | | $281.84 | $630.96 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $229.09
| Professional | | $229.09 | $229.09 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,818.38 / $8,317.64
| Facility | | $954.99 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $616.60 / $1,584.89
| Professional | | $338.84 | $616.60 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $1,258.93
| Facility | | $371.54 | $371.54 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $467.74 / $1,318.26
| Professional | | $371.54 | $467.74 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $407.38 / $562.34
| Facility | | $346.74 | $407.38 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $407.38 / $562.34
| Professional | | $346.74 | $407.38 | $562.34 |
- 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
- $323.59 / $512.86 / $891.25
| Professional | | $323.59 | $512.86 | $891.25 |