- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $3,388.44 / $5,370.32
| Facility | | $309.03 | $3,388.44 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $331.13 / $660.69
| Professional | | $245.47 | $331.13 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,096.48 / $3,548.13
| Facility | | $56.23 | $1,096.48 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $398.11 / $977.24
| Professional | | $234.42 | $398.11 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $288.40 / $660.69
| Facility | | $288.40 | $288.40 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $371.54 / $371.54
| Professional | | $338.84 | $371.54 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $223.87
| Facility | | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $501.19 / $933.25
| Professional | | $281.84 | $501.19 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $354.81 / $8,511.38
| Facility | | $213.80 | $354.81 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $446.68 / $616.60
| Professional | | $354.81 | $446.68 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,454.71 / $7,079.46
| Facility | | $794.33 | $2,454.71 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $407.38 / $831.76
| Professional | | $251.19 | $407.38 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $933.25 / $933.25
| Professional | | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,202.26 / $3,801.89
| Facility | | $56.23 | $1,202.26 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $398.11 / $954.99
| Professional | | $234.42 | $398.11 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,089.30 / $6,165.95
| Facility | | $776.25 | $2,089.30 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.03 / $416.87 / $831.76
| Professional | | $263.03 | $416.87 | $831.76 |