- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,047.13 / $1,778.28
| Facility | | $588.84 | $1,047.13 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $346.74 / $501.19 / $954.99
| Professional | | $346.74 | $501.19 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $1,513.56
| Facility | | $588.84 | $588.84 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $1,122.02
| Professional | | $234.42 | $234.42 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $588.84 / $588.84
| Facility | | $346.74 | $588.84 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $707.95
| Professional | | $588.84 | $588.84 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,258.93 / $1,513.56
| Facility | | $380.19 | $1,258.93 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $724.44 / $2,818.38
| Professional | | $354.81 | $724.44 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $741.31 / $1,621.81
| Facility | | $457.09 | $741.31 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $575.44 / $1,096.48
| Professional | | $407.38 | $575.44 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $549.54 / $1,047.13
| Professional | | $467.74 | $549.54 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,096.48 / $50,118.72
| Facility | | $758.58 | $1,096.48 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $602.56
| Professional | | $588.84 | $588.84 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $588.84 / $707.95
| Facility | | $524.81 | $588.84 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $346.74 / $776.25
| Professional | | $245.47 | $346.74 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $616.60 / $724.44
| Facility | | $478.63 | $616.60 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $588.84 / $1,148.15
| Professional | | $467.74 | $588.84 | $1,148.15 |