- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $2,691.53 / $8,317.64
| Facility | | $478.63 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $165.96 / $758.58
| Professional | | $60.26 | $165.96 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $117.49 / $131.83
| Professional | | $112.20 | $117.49 | $131.83 |
- 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
- $138.04 / $251.19 / $288.40
| Professional | | $138.04 | $251.19 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $446.68 / $537.03
| Facility | | $95.50 | $446.68 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $128.82 / $234.42
| Professional | | $52.48 | $128.82 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $213.80 / $234.42
| Professional | | $165.96 | $213.80 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $165.96 / $269.15
| Professional | | $85.11 | $165.96 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,047.13 / $1,047.13
| Facility | | $1,047.13 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $144.54 / $245.47
| Professional | | $128.82 | $144.54 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $2,089.30 / $7,762.47
| Facility | | $512.86 | $2,089.30 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $154.88 / $467.74
| Professional | | $60.26 | $154.88 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $190.55
| Professional | | $190.55 | $190.55 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.99 / $74.13 / $151.36
| Facility | | $23.99 | $74.13 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.99 / $112.20 / $309.03
| Professional | | $23.99 | $112.20 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $575.44 / $707.95
| Facility | | $302.00 | $575.44 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $125.89 / $229.09
| Professional | | $56.23 | $125.89 | $229.09 |