- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $279.91 / $1,192.42 / $1,511.51
| Facility | | $279.91 | $1,192.42 | $1,511.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $255.72 / $283.37 / $2,222.02
| Professional | | $255.72 | $283.37 | $2,222.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,628.31 / $2,169.80 / $8,459.92
| Facility | | $1,628.31 | $2,169.80 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.54 / $269.54 / $269.54
| Professional | | $269.54 | $269.54 | $269.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.95 / $510.32 / $1,146.36
| Facility | | $327.95 | $510.32 | $1,146.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.89 / $369.80 / $781.31
| Professional | | $181.89 | $369.80 | $781.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.62 / $466.52 / $656.58
| Professional | | $205.62 | $466.52 | $656.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.57 / $940.77 / $2,083.00
| Facility | | $488.57 | $940.77 | $2,083.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.73 / $946.10 / $1,536.21
| Facility | | $293.73 | $946.10 | $1,536.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.18 / $378.05 / $1,427.20
| Professional | | $259.18 | $378.05 | $1,427.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.44 / $518.36 / $691.14
| Professional | | $511.44 | $518.36 | $691.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.25 / $574.91 / $1,146.36
| Facility | | $336.25 | $574.91 | $1,146.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.43 / $399.29 / $781.31
| Professional | | $204.43 | $399.29 | $781.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.57 / $345.57 / $522.50
| Facility | | $345.57 | $345.57 | $522.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.57 / $345.57 / $522.50
| Professional | | $345.57 | $345.57 | $522.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.13 / $207.34 / $518.36
| Professional | | $145.13 | $207.34 | $518.36 |