- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.66 / $1,107.49 / $1,691.80
| Facility | | $327.66 | $1,107.49 | $1,691.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.10 / $327.66 / $2,601.06
| Professional | | $198.10 | $327.66 | $2,601.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,134.11 / $1,511.28 / $8,459.92
| Facility | | $1,134.11 | $1,511.28 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.52 / $315.52 / $315.52
| Professional | | $315.52 | $315.52 | $315.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.89 / $597.39 / $1,341.96
| Facility | | $383.89 | $597.39 | $1,341.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.34 / $393.50 / $914.62
| Professional | | $152.34 | $393.50 | $914.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.69 / $546.10 / $768.59
| Professional | | $240.69 | $546.10 | $768.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $846.09 / $1,208.71 / $3,106.58
| Facility | | $846.09 | $1,208.71 | $3,106.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.84 / $1,107.49 / $1,670.67
| Facility | | $343.84 | $1,107.49 | $1,670.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.85 / $343.84 / $1,670.67
| Professional | | $254.85 | $343.84 | $1,670.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $598.69 / $606.78 / $809.04
| Professional | | $598.69 | $606.78 | $809.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.87 / $672.99 / $1,341.96
| Facility | | $393.87 | $672.99 | $1,341.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.00 / $432.13 / $914.62
| Professional | | $178.00 | $432.13 | $914.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.92 / $404.52 / $404.52
| Facility | | $363.92 | $404.52 | $404.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.92 / $404.52 / $404.52
| Professional | | $363.92 | $404.52 | $404.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.90 / $242.71 / $566.33
| Professional | | $169.90 | $242.71 | $566.33 |