- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $2,238.72 / $3,801.89
| Facility | | $204.17 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $229.09 / $537.03
| Professional | | $162.18 | $229.09 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $630.96 / $3,467.37
| Facility | | $56.23 | $630.96 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $263.03 / $645.65
| Professional | | $154.88 | $263.03 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $436.52
| Facility | | $190.55 | $190.55 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $331.13 / $467.74
| Professional | | $190.55 | $331.13 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $154.88
| Facility | | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $346.74 / $616.60
| Professional | | $169.82 | $346.74 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $239.88 / $7,079.46
| Facility | | $141.25 | $239.88 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $295.12 / $407.38
| Professional | | $234.42 | $295.12 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,862.09 / $3,467.37
| Facility | | $501.19 | $1,862.09 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $269.15 / $549.54
| Professional | | $165.96 | $269.15 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,630.27 / $3,019.95
| Facility | | $2,630.27 | $2,630.27 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $309.03 / $331.13
| Professional | | $295.12 | $309.03 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $691.83 / $3,467.37
| Facility | | $56.23 | $691.83 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $263.03 / $616.60
| Professional | | $154.88 | $263.03 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $269.15 / $549.54
| Professional | | $165.96 | $269.15 | $549.54 |