- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $446.68 / $3,467.37
| Facility | | $218.78 | $446.68 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $234.42 / $851.14
| Professional | | $141.25 | $234.42 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,570.88 / $7,079.46
| Facility | | $2,344.23 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $302.00 / $724.44
| Professional | | $208.93 | $302.00 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $691.83 / $1,096.48
| Facility | | $588.84 | $691.83 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $478.63 / $794.33
| Professional | | $239.88 | $478.63 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $416.87 / $3,801.89
| Facility | | $151.36 | $416.87 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $436.52 / $645.65
| Professional | | $323.59 | $436.52 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $457.09 / $5,754.40
| Facility | | $151.36 | $457.09 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $416.87 / $1,621.81
| Professional | | $218.78 | $416.87 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $309.03
| Professional | | $32.36 | $33.11 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $467.74 / $758.58
| Professional | | $245.47 | $467.74 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $3,715.35 / $3,715.35
| Facility | | $2,511.89 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $501.19 / $1,548.82
| Professional | | $169.82 | $501.19 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $933.25 / $1,318.26
| Professional | | $338.84 | $933.25 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,801.89 / $6,456.54
| Facility | | $2,884.03 | $3,801.89 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $309.03 / $812.83
| Professional | | $147.91 | $309.03 | $812.83 |