- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.02 / $501.78 / $1,010.60
| Facility | | $291.02 | $501.78 | $1,010.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.02 / $425.13 / $741.02
| Professional | | $291.02 | $425.13 | $741.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.38 / $465.83 / $1,004.65
| Professional | | $367.38 | $465.83 | $1,004.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.39 / $51.39 / $578.16
| Facility | | $51.39 | $51.39 | $578.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.39 / $578.16 / $629.54
| Professional | | $51.39 | $578.16 | $629.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.61 / $1,364.45 / $3,438.28
| Facility | | $1,061.61 | $1,364.45 | $3,438.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.62 / $553.66 / $1,475.36
| Professional | | $320.62 | $553.66 | $1,475.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.25 / $388.48 / $950.69
| Facility | | $279.25 | $388.48 | $950.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.04 / $470.39 / $804.78
| Professional | | $343.04 | $470.39 | $804.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60.60 / $60.60 / $60.60
| Facility | | $60.60 | $60.60 | $60.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.60 / $365.81 / $638.59
| Professional | | $60.60 | $365.81 | $638.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.72 / $1,364.45 / $3,820.31
| Facility | | $453.72 | $1,364.45 | $3,820.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.73 / $612.67 / $1,393.99
| Professional | | $320.73 | $612.67 | $1,393.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.00 / $484.92 / $1,080.06
| Professional | | $345.00 | $484.92 | $1,080.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $427.25 / $427.25 / $747.14
| Facility | | $427.25 | $427.25 | $747.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.57 / $538.20 / $946.88
| Professional | | $311.57 | $538.20 | $946.88 |