- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $5,370.32 / $8,511.38
| Facility | | $537.03 | $5,370.32 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $223.87 / $457.09
| Professional | | $128.82 | $223.87 | $457.09 |
- 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
- $199.53 / $199.53 / $218.78
| Professional | | $199.53 | $199.53 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $245.47
| Facility | | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $239.88 / $446.68
| Professional | | $138.04 | $239.88 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $489.78 / $616.60
| Professional | | $363.08 | $489.78 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $331.13 / $489.78
| Professional | | $190.55 | $331.13 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $3,388.44 / $3,388.44
| Facility | | $3,388.44 | $3,388.44 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $3,981.07 / $8,317.64
| Facility | | $537.03 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $263.03 / $676.08
| Professional | | $141.25 | $263.03 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $524.81
| Facility | | $457.09 | $457.09 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $363.08 / $575.44
| Professional | | $194.98 | $363.08 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $162.18 / $251.19
| Facility | | $138.04 | $162.18 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $245.47 / $380.19
| Professional | | $138.04 | $245.47 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $758.58 / $3,890.45
| Facility | | $223.87 | $758.58 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $229.09 / $398.11
| Professional | | $134.90 | $229.09 | $398.11 |