- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.77 / $497.17 / $1,590.46
| Facility | | $473.77 | $497.17 | $1,590.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.23 / $473.77 / $2,162.11
| Professional | | $425.23 | $473.77 | $2,162.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,771.17 / $3,692.72 / $8,459.92
| Facility | | $2,771.17 | $3,692.72 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $456.22 / $456.22 / $573.19
| Professional | | $456.22 | $456.22 | $573.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.12 / $778.90 / $1,940.67
| Facility | | $385.12 | $778.90 | $1,940.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.28 / $660.30 / $1,322.68
| Professional | | $347.28 | $660.30 | $1,322.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.05 / $467.92 / $988.48
| Professional | | $269.05 | $467.92 | $988.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,955.00 / $1,955.00 / $1,955.00
| Facility | | $1,955.00 | $1,955.00 | $1,955.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.13 / $473.77 / $1,590.46
| Facility | | $421.13 | $473.77 | $1,590.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $421.13 / $473.77 / $2,162.11
| Professional | | $421.13 | $473.77 | $2,162.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $865.65 / $877.35 / $1,169.80
| Professional | | $865.65 | $877.35 | $1,169.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.60 / $944.98 / $1,940.67
| Facility | | $391.60 | $944.98 | $1,940.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $347.61 / $660.30 / $1,322.68
| Professional | | $347.61 | $660.30 | $1,322.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.90 / $584.90 / $882.56
| Facility | | $584.90 | $584.90 | $882.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $584.90 / $584.90 / $882.56
| Professional | | $584.90 | $584.90 | $882.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.66 / $361.05 / $962.80
| Professional | | $245.66 | $361.05 | $962.80 |