- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.20 / $1,643.79 / $3,462.83
| Facility | | $496.20 | $1,643.79 | $3,462.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.56 / $496.20 / $512.03
| Professional | | $332.56 | $496.20 | $512.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.26 / $844.59 / $1,847.55
| Facility | | $554.26 | $844.59 | $1,847.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.08 / $1,097.51 / $3,959.03
| Professional | | $475.08 | $1,097.51 | $3,959.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.99 / $1,122.10 / $1,363.04
| Facility | | $548.99 | $1,122.10 | $1,363.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $475.08 / $527.87 / $1,319.68
| Facility | | $475.08 | $527.87 | $1,319.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.08 / $527.87 / $1,319.68
| Professional | | $475.08 | $527.87 | $1,319.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $527.87 / $527.87 / $739.02
| Facility | | $527.87 | $527.87 | $739.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $527.87 / $923.77 / $1,583.61
| Facility | | $527.87 | $923.77 | $1,583.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.08 / $659.84 / $797.08
| Professional | | $475.08 | $659.84 | $797.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.26 / $844.59 / $1,451.64
| Facility | | $554.26 | $844.59 | $1,451.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $583.82 / $974.37 / $1,293.14
| Professional | | $583.82 | $974.37 | $1,293.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.71 / $221.71 / $591.21
| Professional | | $221.71 | $221.71 | $591.21 |