- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.20 / $741.21 / $1,328.58
| Facility | | $325.20 | $741.21 | $1,328.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.07 / $279.70 / $396.24
| Professional | | $247.07 | $279.70 | $396.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.68 / $279.68 / $1,207.73
| Professional | | $279.68 | $279.68 | $1,207.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.17 / $466.17 / $466.17
| Facility | | $466.17 | $466.17 | $466.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.30 / $466.17 / $466.17
| Professional | | $340.30 | $466.17 | $466.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.40 / $984.78 / $1,209.70
| Facility | | $559.40 | $984.78 | $1,209.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $567.79 / $2,246.94 / $2,246.94
| Professional | | $567.79 | $2,246.94 | $2,246.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.00 / $606.02 / $1,048.88
| Facility | | $294.00 | $606.02 | $1,048.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.48 / $615.34 / $1,011.59
| Professional | | $489.48 | $615.34 | $1,011.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.24 / $466.17 / $845.30
| Professional | | $396.24 | $466.17 | $845.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $1,137.41 / $1,209.70
| Facility | | $555.00 | $1,137.41 | $1,209.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.01 / $508.13 / $1,072.19
| Professional | | $303.01 | $508.13 | $1,072.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.79 / $279.70 / $731.82
| Professional | | $195.79 | $279.70 | $731.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.17 / $536.08 / $536.08
| Facility | | $466.17 | $536.08 | $536.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.24 / $466.17 / $560.29
| Professional | | $396.24 | $466.17 | $560.29 |