- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.08 / $1,127.32 / $2,631.79
| Facility | | $280.08 | $1,127.32 | $2,631.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.18 / $280.08 / $2,118.75
| Professional | | $214.18 | $280.08 | $2,118.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.17 / $636.51 / $1,624.48
| Facility | | $287.17 | $636.51 | $1,624.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.80 / $387.35 / $917.22
| Professional | | $131.80 | $387.35 | $917.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $434.95 / $2,955.70
| Facility | | $59.40 | $434.95 | $2,955.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.93 / $214.18 / $538.42
| Professional | | $149.93 | $214.18 | $538.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.71 / $569.72 / $1,103.03
| Facility | | $240.71 | $569.72 | $1,103.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.40 / $273.01 / $1,006.72
| Professional | | $175.40 | $273.01 | $1,006.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.60 / $329.51 / $444.84
| Professional | | $263.60 | $329.51 | $444.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.56 / $378.94 / $724.92
| Professional | | $296.56 | $378.94 | $724.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.35 / $1,565.17 / $1,565.17
| Facility | | $573.35 | $1,565.17 | $1,565.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,647.55 / $1,647.55 / $2,471.33
| Professional | | $1,647.55 | $1,647.55 | $2,471.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $230.65 / $230.65 / $230.65
| Professional | | $230.65 | $230.65 | $230.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.73 / $395.41 / $946.89
| Facility | | $267.73 | $395.41 | $946.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.10 / $378.94 / $891.68
| Professional | | $179.10 | $378.94 | $891.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,156.58 / $1,156.58 / $1,156.58
| Professional | | $1,156.58 | $1,156.58 | $1,156.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.61 / $296.56 / $448.12
| Professional | | $263.61 | $296.56 | $448.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.38 / $143.99 / $654.66
| Professional | | $138.38 | $143.99 | $654.66 |