- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.10 / $459.02 / $14,464.32
| Facility | | $235.10 | $459.02 | $14,464.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.40 / $213.66 / $408.77
| Professional | | $146.40 | $213.66 | $408.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.84 / $2,141.39 / $4,357.93
| Facility | | $80.84 | $2,141.39 | $4,357.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.27 / $381.84 / $1,332.40
| Professional | | $236.27 | $381.84 | $1,332.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.89 / $115.89 / $193.07
| Facility | | $115.89 | $115.89 | $193.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.81 / $337.91 / $536.30
| Professional | | $217.81 | $337.91 | $536.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.10 / $315.52 / $540.92
| Facility | | $158.10 | $315.52 | $540.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.95 / $312.61 / $433.88
| Professional | | $163.95 | $312.61 | $433.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.66 / $329.40 / $541.91
| Professional | | $51.66 | $329.40 | $541.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.84 / $233.75 / $244.95
| Facility | | $80.84 | $233.75 | $244.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.52 / $328.43 / $453.36
| Professional | | $242.52 | $328.43 | $453.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,477.31 / $2,250.40 / $4,357.93
| Facility | | $1,477.31 | $2,250.40 | $4,357.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.94 / $309.75 / $422.49
| Professional | | $222.94 | $309.75 | $422.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591.00 / $1,106.00 / $4,911.00
| Facility | | $591.00 | $1,106.00 | $4,911.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.32 / $369.48 / $505.93
| Professional | | $221.32 | $369.48 | $505.93 |