- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.80 / $1,166.13 / $1,579.51
| Facility | | $362.80 | $1,166.13 | $1,579.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.77 / $362.80 / $466.45
| Professional | | $340.77 | $362.80 | $466.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.96 / $440.40 / $1,244.61
| Facility | | $382.96 | $440.40 | $1,244.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.97 / $310.97 / $2,581.03
| Professional | | $310.97 | $310.97 | $2,581.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.28 / $741.14 / $1,390.03
| Facility | | $518.28 | $741.14 | $1,390.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.18 / $487.18 / $487.18
| Professional | | $487.18 | $487.18 | $487.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.24 / $370.57 / $1,179.08
| Facility | | $323.24 | $370.57 | $1,179.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.89 / $497.41 / $1,011.05
| Professional | | $274.89 | $497.41 | $1,011.05 |
- 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
- $747.73 / $747.73 / $879.68
| Professional | | $747.73 | $747.73 | $879.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.28 / $518.28 / $1,684.41
| Professional | | $518.28 | $518.28 | $1,684.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.17 / $831.17 / $831.17
| Facility | | $831.17 | $831.17 | $831.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $901.81 / $2,461.83 / $2,461.83
| Facility | | $901.81 | $2,461.83 | $2,461.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.97 / $310.97 / $2,581.03
| Professional | | $310.97 | $310.97 | $2,581.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.97 / $310.97 / $777.42
| Professional | | $310.97 | $310.97 | $777.42 |