- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,412.54 / $5,495.41
| Facility | | $1,096.48 | $1,412.54 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $436.52 / $741.31
| Professional | | $316.23 | $436.52 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $2,238.72 / $4,168.69
| Facility | | $1,148.15 | $2,238.72 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $562.34 / $676.08 / $741.31
| Professional | | $562.34 | $676.08 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,000.00
| Facility | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $478.63 / $616.60
| Professional | | $371.54 | $478.63 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $549.54 / $891.25
| Facility | | $346.74 | $549.54 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $691.83 / $870.96
| Professional | | $575.44 | $691.83 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $3,630.78 / $5,011.87
| Facility | | $2,691.53 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $676.08 / $758.58
| Professional | | $467.74 | $676.08 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $588.84 / $2,511.89
| Professional | | $338.84 | $588.84 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,630.27 / $4,466.84
| Facility | | $446.68 | $2,630.27 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $501.19 / $724.44
| Professional | | $346.74 | $501.19 | $724.44 |