- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $2,754.23 / $7,079.46
| Facility | | $338.84 | $2,754.23 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $380.19 / $724.44
| Professional | | $234.42 | $380.19 | $724.44 |
- 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
- $239.88 / $354.81 / $602.56
| Professional | | $239.88 | $354.81 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $371.54 / $3,548.13
| Professional | | $275.42 | $371.54 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $398.11 / $707.95
| Professional | | $251.19 | $398.11 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.08 / $467.74 / $549.54
| Professional | | $363.08 | $467.74 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $512.86 / $891.25
| Professional | | $407.38 | $512.86 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $398.11 / $660.69
| Facility | | $239.88 | $398.11 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $281.84 / $281.84
| Professional | | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $323.59 / $6,918.31
| Facility | | $234.42 | $323.59 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $478.63 / $6,918.31
| Professional | | $338.84 | $478.63 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $7,079.46 / $13,803.84
| Facility | | $3,630.78 | $7,079.46 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $363.08 / $645.65
| Professional | | $213.80 | $363.08 | $645.65 |