- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $165.96 / $446.68
| Professional | | $79.43 | $165.96 | $446.68 |
- 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
- $128.82 / $158.49 / $186.21
| Professional | | $128.82 | $158.49 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $158.49 / $158.49
| Facility | | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $169.82 / $331.13
| Professional | | $87.10 | $169.82 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $354.81 / $446.68
| Professional | | $263.03 | $354.81 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $245.47 / $354.81
| Professional | | $123.03 | $245.47 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,698.24 / $2,454.71
| Facility | | $1,230.27 | $1,698.24 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,290.87 / $7,762.47
| Facility | | $588.84 | $2,290.87 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $194.98 / $501.19
| Professional | | $85.11 | $194.98 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $186.21 / $363.08
| Facility | | $186.21 | $186.21 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $190.55 / $457.09
| Professional | | $181.97 | $190.55 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $173.78 / $316.23
| Facility | | $89.13 | $173.78 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $173.78 / $354.81
| Professional | | $38.90 | $173.78 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,584.89 / $3,890.45
| Facility | | $501.19 | $1,584.89 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $158.49 / $295.12
| Professional | | $87.10 | $158.49 | $295.12 |