- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $2,187.76 / $4,073.80
| Facility | | $151.36 | $2,187.76 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $199.53 / $676.08
| Professional | | $75.86 | $199.53 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,071.52 / $6,165.95
| Facility | | $56.23 | $1,071.52 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $194.98 / $489.78
| Professional | | $74.13 | $194.98 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $77.62 / $181.97
| Facility | | $77.62 | $77.62 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.62 / $190.55 / $457.09
| Professional | | $77.62 | $190.55 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $169.82 / $426.58
| Professional | | $85.11 | $169.82 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $177.83 / $7,079.46
| Facility | | $63.10 | $177.83 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $269.15 / $478.63
| Professional | | $194.98 | $269.15 | $478.63 |
- 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
- $75.86 / $177.83 / $426.58
| Professional | | $75.86 | $177.83 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $562.34 / $562.34
| Facility | | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $275.42 / $416.87
| Professional | | $223.87 | $275.42 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,071.52 / $6,165.95
| Facility | | $56.23 | $1,071.52 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $194.98 / $489.78
| Professional | | $74.13 | $194.98 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,862.09 / $2,818.38
| Facility | | $501.19 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $194.98 / $436.52
| Professional | | $79.43 | $194.98 | $436.52 |