- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $2,818.38 / $7,585.78
| Facility | | $154.88 | $2,818.38 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $186.21 / $537.03
| Professional | | $91.20 | $186.21 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $190.55 / $501.19
| Professional | | $151.36 | $190.55 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $4,073.80
| Facility | | $123.03 | $123.03 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $239.88
| Professional | | $123.03 | $123.03 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $151.36 / $53,703.18
| Facility | | $34.67 | $151.36 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $251.19 / $691.83
| Professional | | $107.15 | $251.19 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $95.50 / $218.78
| Facility | | $44.67 | $95.50 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $239.88 / $346.74
| Professional | | $177.83 | $239.88 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $229.09 / $354.81
| Professional | | $144.54 | $229.09 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $1,659.59
| Facility | | $707.95 | $707.95 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $50,118.72 / $75,857.76
| Facility | | $109.65 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $234.42 / $446.68
| Professional | | $194.98 | $234.42 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $2,754.23 / $4,897.79
| Facility | | $1,148.15 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $147.91 / $389.05
| Professional | | $75.86 | $147.91 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $72.44 / $107.15 / $389.05
| Facility | | $72.44 | $107.15 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $218.78 / $354.81
| Professional | | $138.04 | $218.78 | $354.81 |