- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $744.38 / $1,220.72 / $2,061.31
| Facility | | $744.38 | $1,220.72 | $2,061.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $574.91 / $727.10 / $799.41
| Professional | | $574.91 | $727.10 | $799.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $892.81 / $6,067.04
| Facility | | $59.40 | $892.81 | $6,067.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.87 / $720.33 / $2,044.87
| Facility | | $625.87 | $720.33 | $2,044.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $694.40 / $1,465.46 / $4,051.46
| Facility | | $694.40 | $1,465.46 | $4,051.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.35 / $946.91 / $1,197.17
| Facility | | $791.35 | $946.91 | $1,197.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $307.75 / $439.64 / $1,105.21
| Professional | | $307.75 | $439.64 | $1,105.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.37 / $676.37 / $1,028.08
| Professional | | $676.37 | $676.37 | $1,028.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.37 / $676.37 / $1,100.22
| Professional | | $676.37 | $676.37 | $1,100.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.36 / $180.36 / $635.78
| Professional | | $180.36 | $180.36 | $635.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.82 / $405.82 / $574.91
| Professional | | $405.82 | $405.82 | $574.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.63 / $1,134.27 / $1,978.38
| Facility | | $603.63 | $1,134.27 | $1,978.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $785.04 / $823.90 / $987.13
| Professional | | $785.04 | $823.90 | $987.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.56 / $1,014.56 / $1,014.56
| Facility | | $1,014.56 | $1,014.56 | $1,014.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.08 / $405.82 / $777.83
| Professional | | $284.08 | $405.82 | $777.83 |