- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.49 / $1,185.23 / $3,321.61
| Facility | | $446.49 | $1,185.23 | $3,321.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $349.30 / $446.49 / $777.98
| Professional | | $349.30 | $446.49 | $777.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.83 / $848.64 / $1,482.29
| Facility | | $316.83 | $848.64 | $1,482.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.67 / $316.26 / $541.20
| Professional | | $4.67 | $316.26 | $541.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $473.55 / $608.85 / $947.10
| Professional | | $473.55 | $608.85 | $947.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.73 / $669.73 / $676.50
| Facility | | $669.73 | $669.73 | $676.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.44 / $969.16 / $3,013.65
| Facility | | $188.44 | $969.16 | $3,013.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.10 / $646.13 / $1,152.38
| Professional | | $308.10 | $646.13 | $1,152.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,598.00 / $3,213.38 / $3,213.38
| Facility | | $1,598.00 | $3,213.38 | $3,213.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,368.97 / $3,368.97 / $5,073.75
| Professional | | $3,368.97 | $3,368.97 | $5,073.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.90 / $676.50 / $1,014.75
| Facility | | $405.90 | $676.50 | $1,014.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $642.67 / $690.03 / $1,014.75
| Professional | | $642.67 | $690.03 | $1,014.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $439.73 / $811.80 / $1,522.12
| Professional | | $439.73 | $811.80 | $1,522.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.43 / $676.50 / $2,266.28
| Facility | | $356.43 | $676.50 | $2,266.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.32 / $777.98 / $1,044.26
| Professional | | $301.32 | $777.98 | $1,044.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.81 / $118.81 / $234.05
| Professional | | $118.81 | $118.81 | $234.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.32 / $676.50 / $913.28
| Professional | | $110.32 | $676.50 | $913.28 |