- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $2,041.74 / $8,317.64
| Facility | | $147.91 | $2,041.74 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $190.55 / $363.08
| Professional | | $123.03 | $190.55 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,570.40 / $2,951.21
| Facility | | $2,137.96 | $2,570.40 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $218.78 / $354.81
| Professional | | $134.90 | $218.78 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $151.36 / $2,511.89
| Professional | | $131.83 | $151.36 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $338.84 / $616.60
| Facility | | $323.59 | $338.84 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $204.17 / $380.19
| Professional | | $128.82 | $204.17 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $257.04 / $426.58
| Professional | | $208.93 | $257.04 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $239.88 / $398.11
| Professional | | $208.93 | $239.88 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $213.80 / $346.74
| Facility | | $131.83 | $213.80 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $147.91 / $371.54
| Professional | | $147.91 | $147.91 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $162.18 / $537.03
| Facility | | $125.89 | $162.18 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $229.09 / $870.96
| Professional | | $177.83 | $229.09 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $812.83 / $2,398.83
| Facility | | $109.65 | $812.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $181.97 / $309.03
| Professional | | $112.20 | $181.97 | $309.03 |