- 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
- $39.81 / $74.13 / $141.25
| Professional | | $39.81 | $74.13 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $64.57 / $128.82
| Professional | | $63.10 | $64.57 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $77.62 / $144.54
| Professional | | $43.65 | $77.62 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.50 / $123.03 / $134.90
| Professional | | $95.50 | $123.03 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $95.50 / $138.04
| Professional | | $43.65 | $95.50 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,344.23 / $8,317.64
| Facility | | $616.60 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $81.28 / $199.53
| Professional | | $41.69 | $81.28 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $134.90 / $158.49
| Facility | | $134.90 | $134.90 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $151.36 / $173.78
| Professional | | $107.15 | $151.36 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.74 / $72.44 / $112.20
| Facility | | $40.74 | $72.44 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $56.23 / $112.20
| Professional | | $40.74 | $56.23 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $512.86 / $3,890.45
| Facility | | $162.18 | $512.86 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $70.79 / $117.49
| Professional | | $41.69 | $70.79 | $117.49 |