- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,778.28 / $4,466.84
| Facility | | $354.81 | $1,778.28 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $269.15 / $724.44
| Professional | | $134.90 | $269.15 | $724.44 |
- 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
- $128.82 / $223.87 / $512.86
| Professional | | $128.82 | $223.87 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $346.74
| Facility | | $154.88 | $154.88 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $263.03 / $416.87
| Professional | | $154.88 | $263.03 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $275.42 / $524.81
| Professional | | $154.88 | $275.42 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $218.78 / $7,079.46
| Facility | | $120.23 | $218.78 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $186.21 / $281.84
| Professional | | $100.00 | $186.21 | $281.84 |
- 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
- $144.54 / $239.88 / $436.52
| Professional | | $144.54 | $239.88 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $562.34 / $4,365.16
| Facility | | $165.96 | $562.34 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $316.23 / $371.54
| Professional | | $147.91 | $316.23 | $371.54 |
- 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
- $128.82 / $218.78 / $501.19
| Professional | | $128.82 | $218.78 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $281.84 / $281.84
| Professional | | $147.91 | $281.84 | $281.84 |
- 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
- $154.88 / $239.88 / $467.74
| Professional | | $154.88 | $239.88 | $467.74 |