- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.45 / $1,926.58 / $2,842.14
| Facility | | $550.45 | $1,926.58 | $2,842.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.74 / $550.45 / $652.39
| Professional | | $407.74 | $550.45 | $652.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.17 / $3,127.72 / $8,459.92
| Facility | | $2,347.17 | $3,127.72 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.05 / $530.05 / $530.05
| Professional | | $530.05 | $530.05 | $530.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.97 / $883.44 / $1,987.74
| Facility | | $454.97 | $883.44 | $1,987.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.81 / $767.04 / $1,536.70
| Professional | | $357.81 | $767.04 | $1,536.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.60 / $543.66 / $1,148.47
| Professional | | $312.60 | $543.66 | $1,148.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $475.50 / $475.50 / $475.50
| Professional | | $475.50 | $475.50 | $475.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.63 / $1,926.58 / $2,806.62
| Facility | | $577.63 | $1,926.58 | $2,806.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.74 / $557.25 / $2,806.62
| Professional | | $407.74 | $557.25 | $2,806.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,005.76 / $1,019.36 / $1,359.14
| Professional | | $1,005.76 | $1,019.36 | $1,359.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.87 / $1,051.96 / $2,254.69
| Facility | | $474.87 | $1,051.96 | $2,254.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $503.99 / $767.04 / $1,536.70
| Professional | | $503.99 | $767.04 | $1,536.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.57 / $679.57 / $747.53
| Facility | | $679.57 | $679.57 | $747.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $679.57 / $679.57 / $747.53
| Professional | | $679.57 | $679.57 | $747.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.42 / $407.74 / $1,155.27
| Professional | | $285.42 | $407.74 | $1,155.27 |