- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $6,025.60 / $16,982.44
| Facility | | $1,659.59 | $6,025.60 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $323.59 / $1,174.90
| Professional | | $158.49 | $323.59 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $4,466.84 / $12,882.50
| Facility | | $2,511.89 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $263.03 / $660.69
| Professional | | $162.18 | $263.03 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $2,398.83 / $7,762.47
| Facility | | $66.07 | $2,398.83 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $346.74 / $758.58
| Professional | | $177.83 | $346.74 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $446.68 / $1,202.26
| Facility | | $331.13 | $446.68 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $323.59 / $691.83
| Professional | | $173.78 | $323.59 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.21 / $229.09 / $524.81
| Professional | | $186.21 | $229.09 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.91 / $338.84 / $660.69
| Professional | | $147.91 | $338.84 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $2,630.27
| Facility | | $54.95 | $56.23 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,691.53 / $2,691.53 / $3,162.28
| Professional | | $2,691.53 | $2,691.53 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $457.09
| Professional | | $275.42 | $275.42 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $338.84 / $562.34
| Facility | | $162.18 | $338.84 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $331.13 / $724.44
| Professional | | $177.83 | $331.13 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $1,096.48
| Professional | | $549.54 | $549.54 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.36 / $331.13 / $426.58
| Professional | | $151.36 | $331.13 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,884.03 / $7,585.78
| Facility | | $1,412.54 | $2,884.03 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $269.15 / $549.54
| Professional | | $141.25 | $269.15 | $549.54 |