- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $616.60 / $5,128.61
| Facility | | $114.82 | $616.60 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $181.97 / $741.31
| Professional | | $112.20 | $181.97 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $501.19 / $2,818.38
| Facility | | $56.23 | $501.19 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $190.55 / $457.09
| Professional | | $107.15 | $190.55 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $138.04 / $316.23
| Facility | | $138.04 | $138.04 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $204.17 / $309.03
| Professional | | $138.04 | $204.17 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $239.88 / $489.78
| Professional | | $131.83 | $239.88 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $218.78 / $7,079.46
| Facility | | $102.33 | $218.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $165.96 / $251.19
| Professional | | $91.20 | $165.96 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $199.53 / $371.54
| Professional | | $120.23 | $199.53 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $229.09
| Professional | | $229.09 | $229.09 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $562.34 / $2,818.38
| Facility | | $56.23 | $562.34 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $190.55 / $446.68
| Professional | | $107.15 | $190.55 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $208.93 / $426.58
| Professional | | $117.49 | $208.93 | $426.58 |