- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.91 / $1,097.44 / $1,687.94
| Facility | | $326.91 | $1,097.44 | $1,687.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.78 / $326.91 / $2,595.08
| Professional | | $197.78 | $326.91 | $2,595.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.86 / $1,387.01 / $8,459.92
| Facility | | $1,040.86 | $1,387.01 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.80 / $314.80 / $314.80
| Professional | | $314.80 | $314.80 | $314.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.00 / $596.41 / $1,339.78
| Facility | | $383.00 | $596.41 | $1,339.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.69 / $388.08 / $913.14
| Professional | | $139.69 | $388.08 | $913.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $240.13 / $544.85 / $766.82
| Professional | | $240.13 | $544.85 | $766.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.78 / $1,219.28 / $1,473.61
| Facility | | $812.78 | $1,219.28 | $1,473.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.05 / $1,029.15 / $1,666.83
| Facility | | $343.05 | $1,029.15 | $1,666.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.58 / $343.05 / $1,666.83
| Professional | | $290.58 | $343.05 | $1,666.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $597.30 / $605.38 / $807.18
| Professional | | $597.30 | $605.38 | $807.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.93 / $671.43 / $1,339.78
| Facility | | $392.93 | $671.43 | $1,339.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.43 / $414.06 / $913.14
| Professional | | $163.43 | $414.06 | $913.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.00 / $403.59 / $403.59
| Facility | | $334.00 | $403.59 | $403.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.00 / $403.59 / $403.59
| Professional | | $334.00 | $403.59 | $403.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.51 / $242.15 / $595.64
| Professional | | $169.51 | $242.15 | $595.64 |