- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $2,951.21 / $7,762.47
| Facility | | $269.15 | $2,951.21 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $323.59 / $676.08
| Professional | | $162.18 | $323.59 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,232.93
| Facility | | $2,630.27 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $323.59 / $812.83
| Professional | | $251.19 | $323.59 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $4,073.80
| Facility | | $234.42 | $234.42 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $478.63
| Professional | | $234.42 | $234.42 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $275.42 / $50,118.72
| Facility | | $34.67 | $275.42 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $354.81 / $870.96
| Professional | | $158.49 | $354.81 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $162.18 / $407.38
| Facility | | $100.00 | $162.18 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $467.74 / $724.44
| Professional | | $380.19 | $467.74 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $346.74 / $691.83
| Professional | | $229.09 | $346.74 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $50,118.72 / $75,857.76
| Facility | | $169.82 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $407.38 / $676.08
| Professional | | $389.05 | $407.38 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,467.37 / $6,165.95
| Facility | | $1,348.96 | $3,467.37 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.54 / $288.40 / $575.44
| Professional | | $144.54 | $288.40 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $223.87 / $575.44
| Facility | | $134.90 | $223.87 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $338.84 / $691.83
| Professional | | $229.09 | $338.84 | $691.83 |