- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $4,466.84 / $8,317.64
| Facility | | $537.03 | $4,466.84 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $138.04 / $512.86
| Professional | | $69.18 | $138.04 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $97.72 / $97.72
| Professional | | $97.72 | $97.72 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $239.88 / $239.88
| Professional | | $208.93 | $239.88 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $117.49 / $199.53
| Professional | | $67.61 | $117.49 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $186.21 / $204.17
| Professional | | $144.54 | $186.21 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $147.91 / $213.80
| Professional | | $93.33 | $147.91 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $933.25 / $1,348.96
| Facility | | $331.13 | $933.25 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $128.82 / $138.04
| Professional | | $117.49 | $128.82 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $3,801.89 / $8,317.64
| Facility | | $588.84 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $128.82 / $309.03
| Professional | | $69.18 | $128.82 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $120.23 / $120.23
| Professional | | $120.23 | $120.23 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.61 / $75.86 / $120.23
| Facility | | $67.61 | $75.86 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $75.86 / $309.03
| Professional | | $67.61 | $75.86 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $676.08 / $3,890.45
| Facility | | $223.87 | $676.08 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $114.82 / $186.21
| Professional | | $67.61 | $114.82 | $186.21 |