- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.27 / $686.51 / $1,660.44
| Facility | | $283.27 | $686.51 | $1,660.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.87 / $283.27 / $446.00
| Professional | | $195.87 | $283.27 | $446.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.42 / $482.16 / $1,245.00
| Facility | | $316.42 | $482.16 | $1,245.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.22 / $588.61 / $2,260.13
| Professional | | $271.22 | $588.61 | $2,260.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.41 / $640.59 / $778.13
| Facility | | $313.41 | $640.59 | $778.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.91 / $318.49 / $426.44
| Professional | | $143.91 | $318.49 | $426.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.35 / $376.69 / $1,032.18
| Facility | | $301.35 | $376.69 | $1,032.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.35 / $512.29 / $932.80
| Professional | | $301.35 | $512.29 | $932.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.00 / $295.02 / $319.78
| Professional | | $75.00 | $295.02 | $319.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.35 / $301.35 / $452.03
| Facility | | $301.35 | $301.35 | $452.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.35 / $527.36 / $904.05
| Facility | | $301.35 | $527.36 | $904.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.22 / $376.69 / $455.04
| Professional | | $271.22 | $376.69 | $455.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.42 / $482.16 / $828.71
| Facility | | $316.42 | $482.16 | $828.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.29 / $586.58 / $700.47
| Professional | | $333.29 | $586.58 | $700.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.57 / $126.57 / $337.51
| Professional | | $126.57 | $126.57 | $337.51 |