- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $9,772.37 / $19,952.62
| Facility | | $630.96 | $9,772.37 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $93.33 / $389.05
| Professional | | $57.54 | $93.33 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $4,466.84 / $12,882.50
| Facility | | $2,511.89 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $117.49 / $251.19
| Professional | | $79.43 | $117.49 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $407.38 / $1,778.28
| Facility | | $66.07 | $407.38 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $112.20 / $234.42
| Professional | | $67.61 | $112.20 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $70.79
| Facility | | $60.26 | $60.26 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $97.72 / $194.98
| Professional | | $63.10 | $97.72 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $70.79 / $134.90
| Professional | | $52.48 | $70.79 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $95.50 / $169.82
| Professional | | $48.98 | $95.50 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $1,288.25
| Facility | | $54.95 | $56.23 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $660.69 / $776.25 / $776.25
| Professional | | $660.69 | $776.25 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.88 / $102.33 / $162.18
| Facility | | $58.88 | $102.33 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $100.00 / $208.93
| Professional | | $63.10 | $100.00 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $295.12
| Professional | | $190.55 | $190.55 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.86 / $91.20 / $117.49
| Professional | | $47.86 | $91.20 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,548.82 / $6,456.54
| Facility | | $588.84 | $1,548.82 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.29 / $85.11 / $199.53
| Professional | | $51.29 | $85.11 | $199.53 |