- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.68 / $354.81 / $831.76
| Facility | | $0.68 | $354.81 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $213.80 / $707.95
| Professional | | $131.83 | $213.80 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $316.23 / $831.76
| Professional | | $169.82 | $316.23 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $602.56 / $954.99
| Facility | | $512.86 | $602.56 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $316.23 / $724.44
| Professional | | $154.88 | $316.23 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $199.53 / $2,238.72
| Facility | | $131.83 | $199.53 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $363.08 / $562.34
| Professional | | $251.19 | $363.08 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $204.17 / $1,202.26
| Facility | | $138.04 | $204.17 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $446.68 / $1,445.44
| Professional | | $190.55 | $446.68 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $186.21
| Professional | | $32.36 | $33.11 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $389.05 / $660.69
| Professional | | $218.78 | $389.05 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $2,238.72 / $2,238.72
| Facility | | $478.63 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $416.87 / $1,380.38
| Professional | | $147.91 | $416.87 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.52 / $691.83 / $977.24
| Professional | | $436.52 | $691.83 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,548.82 / $1,949.84
| Facility | | $977.24 | $1,548.82 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $223.87 / $588.84
| Professional | | $138.04 | $223.87 | $588.84 |