- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $2,818.38 / $7,762.47
| Facility | | $147.91 | $2,818.38 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $162.18 / $416.87
| Professional | | $112.20 | $162.18 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $134.90 / $323.59
| Professional | | $104.71 | $134.90 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $177.83 / $6,165.95
| Facility | | $177.83 | $177.83 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $177.83 / $199.53
| Professional | | $177.83 | $177.83 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $213.80 / $50,118.72
| Facility | | $34.67 | $213.80 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $223.87 / $524.81
| Professional | | $123.03 | $223.87 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $165.96 / $457.09
| Facility | | $125.89 | $165.96 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $208.93 / $302.00
| Professional | | $154.88 | $208.93 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $190.55 / $309.03
| Professional | | $100.00 | $190.55 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $537.03 / $1,995.26
| Facility | | $316.23 | $537.03 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $50,118.72 / $75,857.76
| Facility | | $112.20 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $194.98 / $398.11
| Professional | | $158.49 | $194.98 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,754.23 / $4,897.79
| Facility | | $912.01 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $165.96 / $338.84
| Professional | | $117.49 | $165.96 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $144.54 / $354.81
| Facility | | $104.71 | $144.54 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $173.78 / $323.59
| Professional | | $102.33 | $173.78 | $323.59 |