- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.96 / $1,343.73 / $1,780.50
| Facility | | $408.96 | $1,343.73 | $1,780.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $384.13 / $408.96 / $686.88
| Professional | | $384.13 | $408.96 | $686.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.24 / $675.17 / $1,829.22
| Facility | | $436.24 | $675.17 | $1,829.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.54 / $584.23 / $2,316.84
| Professional | | $350.54 | $584.23 | $2,316.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.23 / $835.45 / $1,566.90
| Facility | | $584.23 | $835.45 | $1,566.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $549.17 / $549.17 / $549.17
| Professional | | $549.17 | $549.17 | $549.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.88 / $422.12 / $1,329.13
| Facility | | $375.88 | $422.12 | $1,329.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.45 / $616.29 / $1,522.83
| Professional | | $303.45 | $616.29 | $1,522.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,472.00 / $9,239.00
| Facility | | $83.43 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $842.94 / $842.94 / $991.70
| Professional | | $842.94 | $842.94 | $991.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.23 / $584.23 / $1,809.30
| Professional | | $584.23 | $584.23 | $1,809.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,016.56 / $2,775.09 / $2,775.09
| Facility | | $1,016.56 | $2,775.09 | $2,775.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.54 / $350.54 / $2,921.15
| Professional | | $350.54 | $350.54 | $2,921.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.38 / $350.54 / $946.55
| Professional | | $245.38 | $350.54 | $946.55 |