- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $1,412.54 / $3,630.78
| Facility | | $138.04 | $1,412.54 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $151.36 / $501.19
| Professional | | $97.72 | $151.36 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $575.44 / $2,818.38
| Facility | | $56.23 | $575.44 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $436.52
| Professional | | $104.71 | $173.78 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $117.49 / $269.15
| Facility | | $117.49 | $117.49 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $199.53 / $323.59
| Professional | | $117.49 | $199.53 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $199.53 / $371.54
| Professional | | $107.15 | $199.53 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $199.53 / $7,079.46
| Facility | | $93.33 | $199.53 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $213.80 / $295.12
| Professional | | $169.82 | $213.80 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $194.98 / $389.05
| Professional | | $109.65 | $194.98 | $389.05 |
- 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
- $181.97 / $213.80 / $257.04
| Professional | | $181.97 | $213.80 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $575.44 / $2,818.38
| Facility | | $56.23 | $575.44 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $173.78 / $436.52
| Professional | | $104.71 | $173.78 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $181.97 / $380.19
| Professional | | $109.65 | $181.97 | $380.19 |