- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.66 / $950.81 / $1,402.65
| Facility | | $271.66 | $950.81 | $1,402.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.18 / $275.01 / $2,156.48
| Professional | | $248.18 | $275.01 | $2,156.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,580.30 / $2,105.83 / $8,459.92
| Facility | | $1,580.30 | $2,105.83 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $261.60 / $261.60 / $261.60
| Professional | | $261.60 | $261.60 | $261.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.27 / $495.32 / $1,112.68
| Facility | | $318.27 | $495.32 | $1,112.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.61 / $358.93 / $758.35
| Professional | | $176.61 | $358.93 | $758.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.55 / $452.76 / $637.22
| Professional | | $199.55 | $452.76 | $637.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.22 / $258.29 / $1,370.77
| Facility | | $167.22 | $258.29 | $1,370.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.07 / $950.81 / $1,402.65
| Facility | | $285.07 | $950.81 | $1,402.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.18 / $300.27 / $1,385.12
| Professional | | $248.18 | $300.27 | $1,385.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.36 / $503.07 / $670.76
| Professional | | $496.36 | $503.07 | $670.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.49 / $557.97 / $1,112.68
| Facility | | $326.49 | $557.97 | $1,112.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.37 / $387.50 / $758.35
| Professional | | $198.37 | $387.50 | $758.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.38 / $335.38 / $507.10
| Facility | | $335.38 | $335.38 | $507.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $335.38 / $335.38 / $507.10
| Professional | | $335.38 | $335.38 | $507.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.86 / $201.23 / $528.88
| Professional | | $140.86 | $201.23 | $528.88 |