- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $151.36 / $338.84
| Professional | | $102.33 | $151.36 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $162.18 / $257.04
| Professional | | $147.91 | $162.18 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $257.04 / $588.84
| Facility | | $147.91 | $257.04 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $165.96 / $309.03
| Professional | | $107.15 | $165.96 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $234.42
| Facility | | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $229.09 / $323.59
| Professional | | $169.82 | $229.09 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $165.96 / $263.03
| Professional | | $117.49 | $165.96 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,344.23 / $8,317.64
| Facility | | $616.60 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $181.97 / $478.63
| Professional | | $107.15 | $181.97 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $151.36 / $323.59
| Facility | | $141.25 | $151.36 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $281.84 / $371.54
| Professional | | $151.36 | $281.84 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $144.54 / $309.03
| Facility | | $102.33 | $144.54 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $144.54 / $309.03
| Professional | | $74.13 | $144.54 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $645.65 / $3,019.95
| Facility | | $85.11 | $645.65 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $144.54 / $245.47
| Professional | | $97.72 | $144.54 | $245.47 |