- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,691.53 / $8,317.64
| Facility | | $660.69 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $213.80 / $407.38
| Professional | | $93.33 | $213.80 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.87 / $234.42 / $398.11
| Professional | | $223.87 | $234.42 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $354.81
| Facility | | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $194.98 / $363.08
| Professional | | $83.18 | $194.98 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $407.38
| Professional | | $295.12 | $295.12 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $245.47 / $389.05
| Professional | | $93.33 | $245.47 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $524.81
| Facility | | $524.81 | $524.81 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $316.23 / $316.23
| Professional | | $316.23 | $316.23 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,344.23 / $8,317.64
| Facility | | $537.03 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $234.42 / $602.56
| Professional | | $93.33 | $234.42 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $426.58
| Professional | | $251.19 | $251.19 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.33 / $158.49 / $316.23
| Facility | | $93.33 | $158.49 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $158.49 / $316.23
| Professional | | $93.33 | $158.49 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,570.40 / $4,265.80
| Facility | | $912.01 | $2,570.40 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $190.55 / $346.74
| Professional | | $85.11 | $190.55 | $346.74 |