- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,890.45 / $8,317.64
| Facility | | $954.99 | $3,890.45 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $380.19 / $831.76
| Professional | | $257.04 | $380.19 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.58 / $549.54 / $645.65
| Professional | | $426.58 | $549.54 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $446.68 / $794.33
| Professional | | $275.42 | $446.68 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $616.60 / $676.08
| Professional | | $478.63 | $616.60 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $562.34 / $851.14
| Professional | | $288.40 | $562.34 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,691.53 / $8,317.64
| Facility | | $912.01 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $467.74 / $1,071.52
| Professional | | $275.42 | $467.74 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $794.33
| Facility | | $346.74 | $346.74 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $691.83 / $933.25
| Professional | | $323.59 | $691.83 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $371.54 / $407.38
| Facility | | $269.15 | $371.54 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $371.54 / $407.38
| Professional | | $269.15 | $371.54 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $10,964.78
| Facility | | $1,348.96 | $3,548.13 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $407.38 / $724.44
| Professional | | $263.03 | $407.38 | $724.44 |