- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $237.25 / $614.88 / $1,565.86
| Facility | | $237.25 | $614.88 | $1,565.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $184.53 / $230.66 / $395.41
| Professional | | $184.53 | $230.66 | $395.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.71 / $197.71 / $197.71
| Professional | | $197.71 | $197.71 | $197.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.00 / $802.03 / $1,690.39
| Facility | | $402.00 | $802.03 | $1,690.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $181.23 / $461.31
| Professional | | $5.00 | $181.23 | $461.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.20 / $326.20 / $329.51
| Facility | | $326.20 | $326.20 | $329.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.64 / $752.97 / $1,467.55
| Facility | | $229.64 | $752.97 | $1,467.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.02 / $185.49 / $517.50
| Professional | | $150.02 | $185.49 | $517.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $807.30 / $1,565.17 / $1,565.17
| Facility | | $807.30 | $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
- Facility
- Modifier
- Low / Median / High Price
- $207.59 / $329.51 / $494.27
| Facility | | $207.59 | $329.51 | $494.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.48 / $329.51 / $411.89
| Professional | | $311.48 | $329.51 | $411.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.18 / $395.41 / $741.40
| Professional | | $214.18 | $395.41 | $741.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.66 / $378.94 / $1,277.08
| Facility | | $230.66 | $378.94 | $1,277.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.54 / $311.48 / $503.04
| Professional | | $152.54 | $311.48 | $503.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.38 / $138.38 / $329.51
| Professional | | $138.38 | $138.38 | $329.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.51 / $329.51 / $444.84
| Professional | | $128.51 | $329.51 | $444.84 |