- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $1,148.15 / $4,570.88
| Facility | | $95.50 | $1,148.15 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $134.90 / $645.65
| Professional | | $52.48 | $134.90 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,584.89 / $1,584.89
| Facility | | $1,202.26 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $181.97 / $501.19
| Professional | | $75.86 | $181.97 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $363.08 / $575.44
| Facility | | $309.03 | $363.08 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $165.96 / $416.87
| Professional | | $61.66 | $165.96 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $134.90 / $2,818.38
| Facility | | $54.95 | $134.90 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $165.96 / $331.13
| Professional | | $91.20 | $165.96 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $141.25 / $1,445.44
| Facility | | $56.23 | $141.25 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $436.52 / $1,047.13
| Professional | | $141.25 | $436.52 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $85.11
| Professional | | $32.36 | $33.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $154.88 / $371.54
| Professional | | $77.62 | $154.88 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $7,762.47 / $7,762.47
| Facility | | $120.23 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $691.83 / $1,071.52
| Professional | | $81.28 | $691.83 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $331.13 / $851.14
| Professional | | $229.09 | $331.13 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,584.89 / $1,949.84
| Facility | | $1,023.29 | $1,584.89 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $169.82 / $501.19
| Professional | | $58.88 | $169.82 | $501.19 |