- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $2,344.23 / $8,317.64
| Facility | | $549.54 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $89.13 / $218.78
| Professional | | $38.02 | $89.13 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $89.13 / $97.72
| Professional | | $85.11 | $89.13 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69.18 / $69.18 / $69.18
| Facility | | $69.18 | $69.18 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $72.44 / $147.91
| Professional | | $40.74 | $72.44 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $141.25 / $177.83
| Professional | | $102.33 | $141.25 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.95 / $97.72 / $144.54
| Professional | | $54.95 | $97.72 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $954.99 / $1,479.11
| Facility | | $309.03 | $954.99 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,995.26 / $7,762.47
| Facility | | $588.84 | $1,995.26 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $91.20 / $229.09
| Professional | | $38.90 | $91.20 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $87.10 / $186.21
| Facility | | $87.10 | $87.10 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $109.65 / $186.21
| Professional | | $74.13 | $109.65 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.20 / $89.13 / $158.49
| Facility | | $18.20 | $89.13 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $83.18 / $158.49
| Professional | | $21.88 | $83.18 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $831.76 / $3,890.45
| Facility | | $223.87 | $831.76 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $70.79 / $125.89
| Professional | | $38.90 | $70.79 | $125.89 |