- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $3,090.30 / $9,332.54
| Facility | | $234.42 | $3,090.30 | $9,332.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $190.55 / $416.87
| Professional | | $151.36 | $190.55 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $165.96 / $323.59
| Professional | | $138.04 | $165.96 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $239.88 / $4,073.80
| Facility | | $239.88 | $239.88 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $239.88 / $239.88
| Professional | | $239.88 | $239.88 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $288.40 / $4,365.16
| Facility | | $34.67 | $288.40 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $251.19 / $630.96
| Professional | | $154.88 | $251.19 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $251.19 / $588.84
| Facility | | $186.21 | $251.19 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $229.09 / $363.08
| Professional | | $173.78 | $229.09 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $154.88
| Facility | | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $218.78 / $346.74
| Professional | | $134.90 | $218.78 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $50,118.72 / $75,857.76
| Facility | | $169.82 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $251.19 / $446.68
| Professional | | $208.93 | $251.19 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,754.23 / $4,897.79
| Facility | | $831.76 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $186.21 / $436.52
| Professional | | $131.83 | $186.21 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $199.53 / $691.83
| Facility | | $134.90 | $199.53 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $199.53 / $416.87
| Professional | | $134.90 | $199.53 | $416.87 |