- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $724.44 / $1,096.48
| Facility | | $229.09 | $724.44 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $295.12 / $1,348.96
| Professional | | $218.78 | $295.12 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $371.54 / $1,122.02
| Facility | | $239.88 | $371.54 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $323.59 / $1,071.52
| Professional | | $194.98 | $323.59 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $645.65 / $933.25
| Facility | | $512.86 | $645.65 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Professional | | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $398.11 / $630.96
| Facility | | $208.93 | $398.11 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $309.03 / $851.14
| Professional | | $177.83 | $309.03 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $549.54
| Professional | | $467.74 | $467.74 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $691.83
| Professional | | $323.59 | $323.59 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $371.54 / $1,122.02
| Facility | | $239.88 | $371.54 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $323.59 / $1,230.27
| Professional | | $194.98 | $323.59 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $323.59 / $398.11
| Facility | | $199.53 | $323.59 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $323.59 / $616.60
| Professional | | $194.98 | $323.59 | $616.60 |