- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.01 / $787.38 / $2,164.46
| Facility | | $226.01 | $787.38 | $2,164.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.24 / $250.12 / $256.14
| Professional | | $164.24 | $250.12 | $256.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.00 / $614.00 / $1,509.76
| Facility | | $244.00 | $614.00 | $1,509.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.90 / $254.07 / $373.10
| Professional | | $228.90 | $254.07 | $373.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $397.78 / $2,703.11
| Facility | | $59.40 | $397.78 | $2,703.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.12 / $195.88 / $489.80
| Professional | | $137.12 | $195.88 | $489.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.82 / $505.37 / $1,008.78
| Facility | | $198.82 | $505.37 | $1,008.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.08 / $301.35 / $406.82
| Professional | | $241.08 | $301.35 | $406.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.22 / $346.55 / $575.58
| Professional | | $271.22 | $346.55 | $575.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.35 / $1,431.41 / $1,431.41
| Facility | | $524.35 | $1,431.41 | $1,431.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,500.72 / $1,500.72 / $2,260.13
| Professional | | $1,500.72 | $1,500.72 | $2,260.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.08 / $361.62 / $799.58
| Facility | | $241.08 | $361.62 | $799.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.35 / $331.49 / $452.03
| Professional | | $301.35 | $331.49 | $452.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.08 / $271.22 / $409.84
| Professional | | $241.08 | $271.22 | $409.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.57 / $136.12 / $665.38
| Professional | | $126.57 | $136.12 | $665.38 |