- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $2,630.27 / $8,317.64
| Facility | | $239.88 | $2,630.27 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $316.23 / $588.84
| Professional | | $190.55 | $316.23 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $354.81 / $602.56
| Professional | | $213.80 | $354.81 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $208.93 / $3,311.31
| Professional | | $186.21 | $208.93 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $281.84 / $616.60
| Facility | | $257.04 | $281.84 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $316.23 / $575.44
| Professional | | $190.55 | $316.23 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $457.09 / $758.58
| Professional | | $371.54 | $457.09 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $371.54 / $457.09
| Professional | | $316.23 | $371.54 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $331.13 / $575.44
| Facility | | $194.98 | $331.13 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $588.84
| Professional | | $208.93 | $208.93 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $234.42 / $870.96
| Facility | | $186.21 | $234.42 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $380.19 / $1,479.11
| Professional | | $275.42 | $380.19 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,818.38 / $5,754.40
| Facility | | $512.86 | $2,818.38 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $288.40 / $512.86
| Professional | | $165.96 | $288.40 | $512.86 |