- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $141.25 / $331.13
| Professional | | $61.66 | $141.25 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $199.53 / $275.42
| Professional | | $97.72 | $199.53 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $331.13 / $575.44
| Facility | | $109.65 | $331.13 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $147.91 / $281.84
| Professional | | $67.61 | $147.91 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $138.04
| Facility | | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $263.03 / $380.19
| Professional | | $194.98 | $263.03 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $186.21 / $302.00
| Professional | | $117.49 | $186.21 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $194.98 / $194.98
| Professional | | $194.98 | $194.98 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,344.23 / $8,317.64
| Facility | | $588.84 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $162.18 / $398.11
| Professional | | $64.57 | $162.18 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $190.55 / $363.08
| Facility | | $169.82 | $190.55 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $251.19 / $389.05
| Professional | | $169.82 | $251.19 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63.10 / $154.88 / $309.03
| Facility | | $63.10 | $154.88 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.55 / $154.88 / $309.03
| Professional | | $24.55 | $154.88 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,905.46 / $4,265.80
| Facility | | $524.81 | $1,905.46 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $123.03 / $218.78
| Professional | | $60.26 | $123.03 | $218.78 |