- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,454.71 / $7,585.78
| Facility | | $537.03 | $2,454.71 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $81.28 / $131.83
| Professional | | $51.29 | $81.28 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $177.83 / $407.38
| Facility | | $91.20 | $177.83 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $79.43 / $125.89
| Professional | | $50.12 | $79.43 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.77 / $138.04 / $138.04
| Facility | | $46.77 | $138.04 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $95.50 / $169.82
| Professional | | $58.88 | $95.50 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $13,489.63 / $13,489.63
| Facility | | $2,951.21 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $724.44 / $724.44
| Professional | | $707.95 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $114.82 / $2,951.21
| Facility | | $54.95 | $114.82 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $83.18 / $162.18
| Professional | | $52.48 | $83.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $63.10
| Professional | | $32.36 | $33.11 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.02 / $173.78 / $218.78
| Professional | | $3.02 | $173.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.29 / $93.33 / $169.82
| Facility | | $51.29 | $93.33 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $95.50 / $165.96
| Professional | | $60.26 | $95.50 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $1,047.13 / $2,691.53
| Facility | | $154.88 | $1,047.13 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $75.86 / $128.82
| Professional | | $47.86 | $75.86 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $91.20 / $91.20
| Professional | | $87.10 | $91.20 | $91.20 |