- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $2,818.38 / $8,317.64
| Facility | | $269.15 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $151.36 / $426.58
| Professional | | $87.10 | $151.36 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $151.36 / $190.55
| Professional | | $117.49 | $151.36 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $181.97 / $194.98
| Professional | | $138.04 | $181.97 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $131.83 / $218.78
| Professional | | $91.20 | $131.83 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $194.98 / $213.80
| Professional | | $151.36 | $194.98 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $151.36 / $223.87
| Professional | | $97.72 | $151.36 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.50 / $549.54 / $912.01
| Facility | | $0.50 | $549.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $2,398.83 / $8,317.64
| Facility | | $389.05 | $2,398.83 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $151.36 / $354.81
| Professional | | $91.20 | $151.36 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $109.65 / $263.03
| Facility | | $109.65 | $109.65 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $199.53 / $245.47
| Professional | | $107.15 | $199.53 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $89.13 / $131.83
| Facility | | $70.79 | $89.13 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $89.13 / $257.04
| Professional | | $70.79 | $89.13 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $616.60 / $3,890.45
| Facility | | $223.87 | $616.60 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $123.03 / $208.93
| Professional | | $91.20 | $123.03 | $208.93 |