- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $2,691.53 / $8,317.64
| Facility | | $478.63 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $239.88 / $912.01
| Professional | | $169.82 | $239.88 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $501.19 / $741.31
| Professional | | $288.40 | $501.19 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $1,230.27 / $2,398.83
| Facility | | $316.23 | $1,230.27 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $245.47 / $691.83
| Professional | | $165.96 | $245.47 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $407.38
| Facility | | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $812.83 / $1,148.15
| Professional | | $602.56 | $812.83 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $549.54 / $912.01
| Professional | | $169.82 | $549.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $6,025.60 / $6,025.60
| Facility | | $6,025.60 | $6,025.60 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,344.23 / $7,762.47
| Facility | | $537.03 | $2,344.23 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $346.74 / $1,071.52
| Professional | | $181.97 | $346.74 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $389.05
| Facility | | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $398.11 / $1,096.48
| Professional | | $281.84 | $398.11 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $407.38 / $912.01
| Facility | | $169.82 | $407.38 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $512.86 / $912.01
| Professional | | $64.57 | $512.86 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $2,398.83 / $6,025.60
| Facility | | $549.54 | $2,398.83 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $208.93 / $478.63
| Professional | | $154.88 | $208.93 | $478.63 |