- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $257.04 / $14,454.40
| Facility | | $131.83 | $257.04 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $138.04 / $309.03
| Professional | | $114.82 | $138.04 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,570.88 / $7,079.46
| Facility | | $2,344.23 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $234.42 / $562.34
| Professional | | $123.03 | $234.42 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $371.54 / $602.56
| Facility | | $323.59 | $371.54 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $398.11 / $446.68
| Professional | | $186.21 | $398.11 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $2,238.72 / $4,786.30
| Facility | | $114.82 | $2,238.72 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $309.03 / $380.19
| Professional | | $223.87 | $309.03 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $2,238.72 / $4,466.84
| Facility | | $114.82 | $2,238.72 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $245.47 / $1,949.84
| Professional | | $125.89 | $245.47 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $173.78
| Professional | | $32.36 | $33.11 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $281.84 / $398.11
| Professional | | $144.54 | $281.84 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,981.07 / $3,981.07
| Facility | | $2,754.23 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $616.60 / $1,995.26
| Professional | | $169.82 | $616.60 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $338.84 / $338.84
| Professional | | $338.84 | $338.84 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $602.56 / $602.56
| Professional | | $371.54 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,884.03 / $5,011.87
| Facility | | $2,344.23 | $2,884.03 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $204.17 / $549.54
| Professional | | $123.03 | $204.17 | $549.54 |