- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,456.54 / $16,982.44
| Facility | | $2,290.87 | $6,456.54 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $275.42 / $977.24
| Professional | | $162.18 | $275.42 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,466.84 / $12,022.64
| Facility | | $2,570.40 | $4,466.84 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $288.40 / $549.54
| Professional | | $186.21 | $288.40 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $338.84 / $1,778.28
| Facility | | $66.07 | $338.84 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $295.12 / $575.44
| Professional | | $177.83 | $295.12 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $281.84 / $281.84
| Facility | | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $288.40 / $524.81
| Professional | | $186.21 | $288.40 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $245.47 / $478.63
| Professional | | $199.53 | $245.47 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $331.13 / $616.60
| Professional | | $173.78 | $331.13 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $1,819.70
| Facility | | $54.95 | $56.23 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,454.71 / $2,454.71
| Professional | | $2,041.74 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $398.11
| Professional | | $234.42 | $234.42 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $288.40 / $501.19
| Facility | | $186.21 | $288.40 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $295.12 / $562.34
| Professional | | $186.21 | $295.12 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $891.25
| Professional | | $575.44 | $575.44 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $331.13 / $436.52
| Professional | | $173.78 | $331.13 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,584.89 / $6,456.54
| Facility | | $588.84 | $1,584.89 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $234.42 / $467.74
| Professional | | $151.36 | $234.42 | $467.74 |