- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $2,818.38 / $7,762.47
| Facility | | $371.54 | $2,818.38 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $331.13 / $691.83
| Professional | | $218.78 | $331.13 | $691.83 |
- 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
- $281.84 / $331.13 / $660.69
| Professional | | $281.84 | $331.13 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $1,258.93 / $4,073.80
| Facility | | $316.23 | $1,258.93 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $316.23 / $467.74
| Professional | | $316.23 | $316.23 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,023.29 / $4,365.16
| Facility | | $380.19 | $1,023.29 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $457.09 / $977.24
| Professional | | $245.47 | $457.09 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $239.88 / $537.03
| Facility | | $75.86 | $239.88 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $478.63 / $758.58
| Professional | | $389.05 | $478.63 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Facility | | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $426.58 / $691.83
| Professional | | $288.40 | $426.58 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $50,118.72 / $75,857.76
| Facility | | $257.04 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $446.68 / $870.96
| Professional | | $398.11 | $446.68 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,128.31
| Facility | | $1,698.24 | $3,630.78 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $309.03 / $724.44
| Professional | | $194.98 | $309.03 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $269.15 / $851.14
| Facility | | $181.97 | $269.15 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $398.11 / $691.83
| Professional | | $269.15 | $398.11 | $691.83 |