- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.97 / $1,055.33 / $1,894.20
| Facility | | $547.97 | $1,055.33 | $1,894.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $374.72 / $507.38 / $960.63
| Professional | | $374.72 | $507.38 | $960.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.50 / $676.50 / $1,758.90
| Facility | | $676.50 | $676.50 | $1,758.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.81 / $373.77 / $1,491.81
| Professional | | $282.81 | $373.77 | $1,491.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.90 / $676.50 / $676.50
| Facility | | $405.90 | $676.50 | $676.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $493.85 / $676.50 / $676.50
| Professional | | $493.85 | $676.50 | $676.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $827.42 / $1,429.12 / $1,806.05
| Facility | | $827.42 | $1,429.12 | $1,806.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.74 / $915.63 / $2,184.48
| Professional | | $410.74 | $915.63 | $2,184.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $879.45 / $1,522.13
| Facility | | $319.00 | $879.45 | $1,522.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.55 / $710.33 / $1,238.00
| Professional | | $473.55 | $710.33 | $1,238.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.03 / $676.50 / $1,226.69
| Professional | | $575.03 | $676.50 | $1,226.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.50 / $1,429.12 / $1,806.05
| Facility | | $254.50 | $1,429.12 | $1,806.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.40 / $876.77 / $2,029.50
| Professional | | $426.40 | $876.77 | $2,029.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.13 / $405.90 / $1,056.56
| Professional | | $284.13 | $405.90 | $1,056.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $717.09 / $717.09 / $925.72
| Facility | | $717.09 | $717.09 | $925.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.03 / $710.62 / $1,006.82
| Professional | | $575.03 | $710.62 | $1,006.82 |