- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $427.57 / $1,496.49 / $2,207.69
| Facility | | $427.57 | $1,496.49 | $2,207.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.62 / $427.57 / $3,394.20
| Professional | | $322.62 | $427.57 | $3,394.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,823.21 / $2,429.52 / $8,459.92
| Facility | | $1,823.21 | $2,429.52 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $411.74 / $411.74 / $411.74
| Professional | | $411.74 | $411.74 | $411.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.96 / $779.75 / $1,751.61
| Facility | | $500.96 | $779.75 | $1,751.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.71 / $563.86 / $1,193.82
| Professional | | $248.71 | $563.86 | $1,193.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.08 / $712.62 / $1,002.95
| Professional | | $314.08 | $712.62 | $1,002.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.69 / $1,496.49 / $2,180.10
| Facility | | $448.69 | $1,496.49 | $2,180.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $332.56 / $448.69 / $2,180.10
| Professional | | $332.56 | $448.69 | $2,180.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $781.25 / $791.80 / $1,055.74
| Professional | | $781.25 | $791.80 | $1,055.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $513.83 / $878.22 / $1,751.61
| Facility | | $513.83 | $878.22 | $1,751.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $343.05 / $565.03 / $1,193.82
| Professional | | $343.05 | $565.03 | $1,193.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.50 / $527.87 / $527.87
| Facility | | $261.50 | $527.87 | $527.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.50 / $527.87 / $527.87
| Professional | | $261.50 | $527.87 | $527.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $221.71 / $316.72 / $739.02
| Professional | | $221.71 | $316.72 | $739.02 |