- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $1,905.46 / $3,715.35
| Facility | | $112.20 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $169.82 / $512.86
| Professional | | $109.65 | $169.82 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $707.95 / $2,951.21
| Facility | | $56.23 | $707.95 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $181.97 / $457.09
| Professional | | $114.82 | $181.97 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $346.74
| Facility | | $151.36 | $151.36 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $269.15 / $398.11
| Professional | | $173.78 | $269.15 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $223.87 / $457.09
| Professional | | $134.90 | $223.87 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $501.19 / $7,079.46
| Facility | | $120.23 | $501.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $147.91 / $251.19
| Professional | | $91.20 | $147.91 | $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
- $141.25 / $229.09 / $380.19
| Professional | | $141.25 | $229.09 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $588.84 / $2,041.74
| Facility | | $173.78 | $588.84 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $263.03 / $309.03
| Professional | | $263.03 | $263.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $741.31 / $2,951.21
| Facility | | $56.23 | $741.31 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $181.97 / $446.68
| Professional | | $114.82 | $181.97 | $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
- $131.83 / $199.53 / $407.38
| Professional | | $131.83 | $199.53 | $407.38 |