- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.71 / $520.98 / $1,166.98
| Facility | | $383.71 | $520.98 | $1,166.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.78 / $496.03 / $970.40
| Professional | | $416.78 | $496.03 | $970.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.71 / $212.55 / $941.92
| Professional | | $166.71 | $212.55 | $941.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.78 / $416.78 / $416.78
| Facility | | $416.78 | $416.78 | $416.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $304.25 / $416.78 / $416.78
| Professional | | $304.25 | $416.78 | $416.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.92 / $884.33 / $1,022.77
| Facility | | $749.92 | $884.33 | $1,022.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.69 / $608.27 / $2,008.88
| Professional | | $507.69 | $608.27 | $2,008.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $416.78 / $937.76
| Facility | | $332.00 | $416.78 | $937.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.75 / $512.64 / $904.41
| Professional | | $291.75 | $512.64 | $904.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.26 / $416.78 / $755.74
| Professional | | $354.26 | $416.78 | $755.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.60 / $1,056.03 / $1,438.47
| Facility | | $30.60 | $1,056.03 | $1,438.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $880.46 / $1,499.84
| Facility | | $555.00 | $880.46 | $1,499.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.58 / $416.78 / $958.59
| Professional | | $312.58 | $416.78 | $958.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $166.67 / $250.07 / $731.41
| Professional | | $166.67 | $250.07 | $731.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.78 / $479.29 / $479.29
| Facility | | $416.78 | $479.29 | $479.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.26 / $416.78 / $500.94
| Professional | | $354.26 | $416.78 | $500.94 |