- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $1,479.11 / $3,630.78
| Facility | | $208.93 | $1,479.11 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $229.09 / $602.56
| Professional | | $97.72 | $229.09 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $1,584.89 / $19,498.45
| Facility | | $257.04 | $1,584.89 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $239.88 / $1,659.59
| Professional | | $102.33 | $239.88 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $288.40
| Facility | | $123.03 | $123.03 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $288.40 / $537.03
| Professional | | $144.54 | $288.40 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $1,096.48
| Facility | | $446.68 | $478.63 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $245.47 / $537.03
| Professional | | $114.82 | $245.47 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $380.19 / $7,079.46
| Facility | | $107.15 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $398.11 / $562.34
| Professional | | $288.40 | $398.11 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,949.84 / $7,079.46
| Facility | | $346.74 | $1,949.84 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $275.42 / $676.08
| Professional | | $125.89 | $275.42 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $724.44 / $1,819.70
| Facility | | $478.63 | $724.44 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $263.03 / $436.52
| Professional | | $107.15 | $263.03 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $1,584.89 / $19,498.45
| Facility | | $257.04 | $1,584.89 | $19,498.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $239.88 / $1,659.59
| Professional | | $102.33 | $239.88 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,041.74 / $5,623.41
| Facility | | $467.74 | $2,041.74 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $234.42 / $616.60
| Professional | | $104.71 | $234.42 | $616.60 |