- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $3,235.94 / $8,317.64
| Facility | | $389.05 | $3,235.94 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $380.19 / $758.58
| Professional | | $309.03 | $380.19 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,981.07 / $4,466.84
| Facility | | $3,090.30 | $3,981.07 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $524.81 / $912.01
| Professional | | $363.08 | $524.81 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $380.19 / $549.54 / $3,548.13
| Professional | | $380.19 | $549.54 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $416.87
| Facility | | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $398.11 / $776.25
| Professional | | $316.23 | $398.11 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $457.09 / $549.54
| Professional | | $354.81 | $457.09 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $467.74 / $812.83
| Professional | | $371.54 | $467.74 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $436.52 / $691.83
| Facility | | $323.59 | $436.52 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $288.40 / $288.40
| Professional | | $288.40 | $288.40 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $426.58 / $1,479.11
| Facility | | $281.84 | $426.58 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $426.58 / $1,479.11
| Professional | | $281.84 | $426.58 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,230.27 / $2,511.89
| Facility | | $229.09 | $1,230.27 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $380.19 / $676.08
| Professional | | $245.47 | $380.19 | $676.08 |