- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $302.00 / $6,606.93
| Facility | | $199.53 | $302.00 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $154.88 / $316.23
| Professional | | $120.23 | $154.88 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.25 / $245.47 / $794.33
| Professional | | $141.25 | $245.47 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $524.81 / $776.25
| Facility | | $389.05 | $524.81 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $436.52 / $602.56
| Professional | | $165.96 | $436.52 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $309.03 / $12,882.50
| Facility | | $144.54 | $309.03 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.15 / $323.59 / $436.52
| Professional | | $269.15 | $323.59 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $269.15 / $1,348.96
| Facility | | $128.82 | $269.15 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $389.05 / $3,981.07
| Professional | | $181.97 | $389.05 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $208.93
| Professional | | $32.36 | $33.11 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $398.11 / $977.24
| Professional | | $204.17 | $398.11 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,348.96 / $1,348.96
| Facility | | $724.44 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $1,819.70 / $3,981.07
| Professional | | $208.93 | $1,819.70 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $380.19
| Professional | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $691.83 / $1,023.29
| Professional | | $316.23 | $691.83 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $8,317.64 / $10,964.78
| Facility | | $8,317.64 | $8,317.64 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $281.84 / $794.33
| Professional | | $162.18 | $281.84 | $794.33 |