- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,691.53 / $8,317.64
| Facility | | $537.03 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $309.03 / $660.69
| Professional | | $245.47 | $309.03 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $199.53 / $295.12
| Professional | | $194.98 | $199.53 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $416.87 / $467.74
| Professional | | $257.04 | $416.87 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $446.68 / $537.03
| Facility | | $208.93 | $446.68 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $288.40 / $501.19
| Professional | | $239.88 | $288.40 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $416.87 / $457.09
| Professional | | $323.59 | $416.87 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $338.84 / $436.52
| Professional | | $234.42 | $338.84 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,659.59 / $1,659.59
| Facility | | $1,659.59 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $269.15 / $269.15
| Professional | | $245.47 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,089.30 / $7,762.47
| Facility | | $537.03 | $2,089.30 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $316.23 / $758.58
| Professional | | $245.47 | $316.23 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $275.42
| Professional | | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.79 / $14.79 / $269.15
| Facility | | $14.79 | $14.79 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $257.04 / $309.03
| Professional | | $14.79 | $257.04 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $616.60 / $3,890.45
| Facility | | $223.87 | $616.60 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $275.42 / $501.19
| Professional | | $208.93 | $275.42 | $501.19 |