- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.44 / $985.12 / $1,651.52
| Facility | | $503.44 | $985.12 | $1,651.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.29 / $492.56 / $631.63
| Professional | | $430.29 | $492.56 | $631.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $579.48 / $579.48 / $1,506.65
| Facility | | $579.48 | $579.48 | $1,506.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.44 / $350.58 / $1,307.81
| Professional | | $276.44 | $350.58 | $1,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $347.69 / $579.48 / $579.48
| Facility | | $347.69 | $579.48 | $579.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.02 / $579.48 / $579.48
| Professional | | $423.02 | $579.48 | $579.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.92 / $1,173.70 / $5,951.59
| Facility | | $404.92 | $1,173.70 | $5,951.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $430.98 / $674.48 / $3,720.19
| Professional | | $430.98 | $674.48 | $3,720.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.00 / $579.48 / $1,303.83
| Facility | | $250.00 | $579.48 | $1,303.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $231.79 / $347.69 / $1,060.45
| Professional | | $231.79 | $347.69 | $1,060.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $492.56 / $579.48 / $769.27
| Professional | | $492.56 | $579.48 | $769.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.27 / $1,229.06 / $5,865.18
| Facility | | $387.27 | $1,229.06 | $5,865.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.04 / $796.72 / $1,193.73
| Professional | | $442.04 | $796.72 | $1,193.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.38 / $318.70 / $851.10
| Professional | | $243.38 | $318.70 | $851.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.39 / $666.39 / $2,134.86
| Facility | | $666.39 | $666.39 | $2,134.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $510.79 / $647.80 / $778.21
| Professional | | $510.79 | $647.80 | $778.21 |