- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.81 / $1,409.31 / $2,167.58
| Facility | | $419.81 | $1,409.31 | $2,167.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.97 / $419.81 / $440.54
| Professional | | $310.97 | $419.81 | $440.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,790.09 / $2,385.38 / $8,459.92
| Facility | | $1,790.09 | $2,385.38 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.26 / $404.26 / $404.26
| Professional | | $404.26 | $404.26 | $404.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.84 / $765.72 / $1,720.09
| Facility | | $491.84 | $765.72 | $1,720.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.76 / $478.59 / $928.41
| Professional | | $238.76 | $478.59 | $928.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.38 / $699.68 / $984.73
| Professional | | $308.38 | $699.68 | $984.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,043.76 / $1,043.76 / $1,043.76
| Facility | | $1,043.76 | $1,043.76 | $1,043.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.54 / $1,409.31 / $2,140.50
| Facility | | $440.54 | $1,409.31 | $2,140.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $340.15 / $424.99 / $2,140.50
| Professional | | $340.15 | $424.99 | $2,140.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $767.05 / $777.42 / $1,036.56
| Professional | | $767.05 | $777.42 | $1,036.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.38 / $862.24 / $1,720.09
| Facility | | $504.38 | $862.24 | $1,720.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.28 / $493.26 / $931.96
| Professional | | $243.28 | $493.26 | $931.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.28 / $518.28 / $570.11
| Facility | | $518.28 | $518.28 | $570.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $518.28 / $518.28 / $570.11
| Professional | | $518.28 | $518.28 | $570.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.68 / $310.97 / $777.42
| Professional | | $217.68 | $310.97 | $777.42 |