- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $1,479.11 / $3,235.94
| Facility | | $275.42 | $1,479.11 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $269.15 / $912.01
| Professional | | $107.15 | $269.15 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,174.90 / $3,801.89
| Facility | | $56.23 | $1,174.90 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $281.84 / $758.58
| Professional | | $114.82 | $281.84 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $288.40
| Facility | | $123.03 | $123.03 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $398.11 / $724.44
| Professional | | $177.83 | $398.11 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $263.03 / $630.96
| Professional | | $134.90 | $263.03 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $380.19 / $7,079.46
| Facility | | $97.72 | $380.19 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $398.11 / $549.54
| Professional | | $323.59 | $398.11 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $281.84 / $724.44
| Professional | | $114.82 | $281.84 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,230.27 / $3,890.45
| Facility | | $891.25 | $1,230.27 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $346.74 / $363.08
| Professional | | $125.89 | $346.74 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,174.90 / $3,801.89
| Facility | | $56.23 | $1,174.90 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $281.84 / $758.58
| Professional | | $114.82 | $281.84 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $6,165.95
| Facility | | $954.99 | $2,344.23 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $288.40 / $707.95
| Professional | | $120.23 | $288.40 | $707.95 |