- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $2,951.21 / $9,120.11
| Facility | | $295.12 | $2,951.21 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $295.12 / $776.25
| Professional | | $186.21 | $295.12 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,232.93
| Facility | | $2,630.27 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $316.23 / $794.33
| Professional | | $251.19 | $316.23 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,258.93 / $4,073.80
| Facility | | $295.12 | $1,258.93 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $489.78
| Professional | | $295.12 | $295.12 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,318.26 / $50,118.72
| Facility | | $354.81 | $1,318.26 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $446.68 / $1,148.15
| Professional | | $208.93 | $446.68 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $234.42 / $588.84
| Facility | | $50.12 | $234.42 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $549.54 / $776.25
| Professional | | $407.38 | $549.54 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $436.52 / $831.76
| Professional | | $245.47 | $436.52 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $50,118.72 / $75,857.76
| Facility | | $186.21 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $426.58 / $691.83
| Professional | | $398.11 | $426.58 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,981.07 / $8,317.64
| Facility | | $1,862.09 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $338.84 / $794.33
| Professional | | $199.53 | $338.84 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $223.87 / $549.54
| Facility | | $169.82 | $223.87 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $371.54 / $676.08
| Professional | | $245.47 | $371.54 | $676.08 |