- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,691.53 / $8,317.64
| Facility | | $616.60 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $229.09 / $457.09
| Professional | | $144.54 | $229.09 | $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
- $257.04 / $263.03 / $446.68
| Professional | | $257.04 | $263.03 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Facility | | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $245.47 / $446.68
| Professional | | $151.36 | $245.47 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $467.74 / $588.84
| Professional | | $338.84 | $467.74 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $323.59 / $467.74
| Professional | | $194.98 | $323.59 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $5,623.41
| Facility | | $3,801.89 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,344.23 / $7,762.47
| Facility | | $537.03 | $2,344.23 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $263.03 / $676.08
| Professional | | $158.49 | $263.03 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $512.86
| Facility | | $467.74 | $467.74 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $380.19 / $602.56
| Professional | | $204.17 | $380.19 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $177.83 / $575.44
| Facility | | $138.04 | $177.83 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $239.88 / $575.44
| Professional | | $147.91 | $239.88 | $575.44 |
- 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
- $147.91 / $234.42 / $389.05
| Professional | | $147.91 | $234.42 | $389.05 |