- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $427.89 / $1,368.85 / $2,079.04
| Facility | | $427.89 | $1,368.85 | $2,079.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.07 / $407.75 / $503.40
| Professional | | $10.07 | $407.75 | $503.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,738.69 / $2,257.80 / $8,639.91
| Facility | | $1,738.69 | $2,257.80 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $392.65 / $392.65 / $392.65
| Professional | | $392.65 | $392.65 | $392.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.86 / $654.41 / $1,472.45
| Facility | | $330.86 | $654.41 | $1,472.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.00 / $525.00 / $656.25
| Professional | | $525.00 | $525.00 | $656.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.56 / $297.01 / $681.60
| Professional | | $231.56 | $297.01 | $681.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.00 / $794.72 / $1,381.08
| Facility | | $606.00 | $794.72 | $1,381.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.50 / $1,497.61 / $2,079.04
| Facility | | $518.50 | $1,497.61 | $2,079.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $266.80 / $397.69 / $2,079.04
| Professional | | $266.80 | $397.69 | $2,079.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.76 / $731.97 / $1,670.11
| Facility | | $351.76 | $731.97 | $1,670.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.00 / $525.00 / $656.25
| Professional | | $525.00 | $525.00 | $656.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.40 / $503.40 / $553.74
| Facility | | $503.40 | $503.40 | $553.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.99 / $503.40 / $553.74
| Professional | | $442.99 | $503.40 | $553.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.43 / $302.04 / $855.78
| Professional | | $211.43 | $302.04 | $855.78 |