- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.57 / $358.57 / $2,296.71
| Facility | | $358.57 | $358.57 | $2,296.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.85 / $358.57 / $2,296.71
| Professional | | $260.85 | $358.57 | $2,296.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $557.22 / $557.22 / $636.82
| Professional | | $557.22 | $557.22 | $636.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.33 / $1,121.77 / $2,526.84
| Facility | | $272.33 | $1,121.77 | $2,526.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.00 / $412.43 / $573.86
| Professional | | $291.00 | $412.43 | $573.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.00 / $942.40 / $1,682.86
| Facility | | $97.00 | $942.40 | $1,682.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $1,056.19 / $2,460.21
| Professional | | $100.00 | $1,056.19 | $2,460.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $372.31 / $380.63 / $425.50
| Facility | | $372.31 | $380.63 | $425.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.86 / $277.86 / $405.78
| Professional | | $277.86 | $277.86 | $405.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.50 / $510.60 / $875.63
| Professional | | $425.50 | $510.60 | $875.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $477.62 / $557.22 / $1,209.97
| Professional | | $477.62 | $557.22 | $1,209.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,218.09 / $3,301.32 / $3,781.14
| Facility | | $1,218.09 | $3,301.32 | $3,781.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,654.76 / $4,766.49 / $4,766.49
| Professional | | $4,654.76 | $4,766.49 | $4,766.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,072.28 / $2,072.28 / $2,072.28
| Professional | | $2,072.28 | $2,072.28 | $2,072.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.28 / $690.08 / $796.03
| Facility | | $192.28 | $690.08 | $796.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.86 / $380.63 / $757.67
| Professional | | $277.86 | $380.63 | $757.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,502.46 / $1,502.46 / $1,502.46
| Professional | | $1,502.46 | $1,502.46 | $1,502.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.50 / $636.82 / $638.25
| Professional | | $425.50 | $636.82 | $638.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $280.36 / $344.32 / $735.28
| Professional | | $280.36 | $344.32 | $735.28 |