- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,890.45 / $8,317.64
| Facility | | $954.99 | $3,890.45 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $199.53 / $398.11
| Professional | | $114.82 | $199.53 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $5,248.07 / $57,543.99
| Facility | | $5,011.87 | $5,248.07 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $218.78 / $218.78
| Professional | | $186.21 | $218.78 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $208.93 / $389.05
| Professional | | $125.89 | $208.93 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $331.13 / $371.54
| Professional | | $257.04 | $331.13 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $257.04 / $380.19
| Professional | | $131.83 | $257.04 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,691.53 / $8,317.64
| Facility | | $912.01 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $234.42 / $602.56
| Professional | | $120.23 | $234.42 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $177.83 / $457.09
| Facility | | $177.83 | $177.83 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $380.19 / $457.09
| Professional | | $186.21 | $380.19 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $208.93 / $407.38
| Facility | | $112.20 | $208.93 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $208.93 / $407.38
| Professional | | $75.86 | $208.93 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,754.23 / $11,481.54
| Facility | | $912.01 | $2,754.23 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $186.21 / $331.13
| Professional | | $109.65 | $186.21 | $331.13 |