- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.72 / $1,387.57 / $2,508.69
| Facility | | $325.72 | $1,387.57 | $2,508.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.57 / $329.74 / $2,585.63
| Professional | | $297.57 | $329.74 | $2,585.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,894.81 / $2,524.92 / $8,459.92
| Facility | | $1,894.81 | $2,524.92 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.64 / $313.64 / $313.64
| Professional | | $313.64 | $313.64 | $313.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.61 / $594.00 / $1,334.35
| Facility | | $381.61 | $594.00 | $1,334.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.69 / $430.44 / $909.43
| Professional | | $211.69 | $430.44 | $909.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.26 / $542.86 / $764.03
| Professional | | $239.26 | $542.86 | $764.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.76 / $773.67 / $1,220.23
| Facility | | $326.76 | $773.67 | $1,220.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.80 / $1,141.60 / $2,114.29
| Facility | | $341.80 | $1,141.60 | $2,114.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.57 / $360.05 / $1,660.76
| Professional | | $297.57 | $360.05 | $1,660.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $595.14 / $603.17 / $804.24
| Professional | | $595.14 | $603.17 | $804.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.35 / $669.00 / $1,334.35
| Facility | | $391.35 | $669.00 | $1,334.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.01 / $464.66 / $909.43
| Professional | | $238.01 | $464.66 | $909.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $402.12 / $402.12 / $608.03
| Facility | | $402.12 | $402.12 | $608.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.12 / $402.12 / $608.03
| Professional | | $402.12 | $402.12 | $608.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.41 / $230.41 / $230.41
| Facility | | $230.41 | $230.41 | $230.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $168.89 / $241.27 / $634.13
| Professional | | $168.89 | $241.27 | $634.13 |