- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $2,691.53 / $7,585.78
| Facility | | $234.42 | $2,691.53 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $457.09 / $912.01
| Professional | | $141.25 | $457.09 | $912.01 |
- 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
- $562.34 / $691.83 / $1,479.11
| Professional | | $562.34 | $691.83 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $4,073.80
| Facility | | $213.80 | $213.80 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $831.76
| Professional | | $213.80 | $213.80 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $239.88 / $50,118.72
| Facility | | $34.67 | $239.88 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $524.81 / $1,778.28
| Professional | | $165.96 | $524.81 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $190.55 / $478.63
| Facility | | $144.54 | $190.55 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $676.08 / $977.24
| Professional | | $562.34 | $676.08 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.87 / $691.83 / $1,174.90
| Professional | | $416.87 | $691.83 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $50,118.72 / $75,857.76
| Facility | | $380.19 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $870.96 / $1,348.96
| Professional | | $724.44 | $870.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,754.23 / $4,897.79
| Facility | | $1,318.26 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $457.09 / $1,174.90
| Professional | | $131.83 | $457.09 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $177.83 / $407.38
| Facility | | $112.20 | $177.83 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $331.13 / $575.44 / $954.99
| Professional | | $331.13 | $575.44 | $954.99 |