- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $3,090.30 / $7,762.47
| Facility | | $338.84 | $3,090.30 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $380.19 / $851.14
| Professional | | $162.18 | $380.19 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,232.93
| Facility | | $2,630.27 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $354.81 / $977.24
| Professional | | $281.84 | $354.81 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $6,165.95
| Facility | | $229.09 | $229.09 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $549.54
| Professional | | $229.09 | $229.09 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $275.42 / $50,118.72
| Facility | | $34.67 | $275.42 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $512.86 / $1,380.38
| Professional | | $190.55 | $512.86 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $269.15 / $549.54
| Facility | | $162.18 | $269.15 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $363.08 / $660.69
| Professional | | $181.97 | $363.08 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $478.63 / $933.25
| Professional | | $316.23 | $478.63 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,137.96 / $2,691.53
| Facility | | $2,137.96 | $2,137.96 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $50,118.72 / $75,857.76
| Facility | | $173.78 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $501.19 / $812.83
| Professional | | $398.11 | $501.19 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,467.37 / $6,165.95
| Facility | | $1,698.24 | $3,467.37 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $331.13 / $831.76
| Professional | | $141.25 | $331.13 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $208.93 / $575.44
| Facility | | $131.83 | $208.93 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $426.58 / $776.25
| Professional | | $302.00 | $426.58 | $776.25 |