- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $4,168.69 / $9,332.54
| Facility | | $245.47 | $4,168.69 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $141.25 / $281.84
| Professional | | $104.71 | $141.25 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $229.09 / $575.44
| Professional | | $117.49 | $229.09 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $371.54 / $588.84
| Facility | | $316.23 | $371.54 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $371.54 / $426.58
| Professional | | $165.96 | $371.54 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $4,466.84 / $8,912.51
| Facility | | $131.83 | $4,466.84 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $295.12 / $371.54
| Professional | | $213.80 | $295.12 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $5,128.61 / $8,317.64
| Facility | | $120.23 | $5,128.61 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $213.80 / $891.25
| Professional | | $120.23 | $213.80 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $165.96
| Professional | | $32.36 | $33.11 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $275.42 / $467.74
| Professional | | $141.25 | $275.42 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,943.28 / $7,943.28
| Facility | | $5,370.32 | $7,943.28 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $562.34 / $870.96
| Professional | | $162.18 | $562.34 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $645.65 / $724.44
| Professional | | $100.00 | $645.65 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,413.10 / $9,120.11
| Facility | | $4,897.79 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $186.21 / $501.19
| Professional | | $109.65 | $186.21 | $501.19 |