- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $484.31 / $1,695.08 / $2,500.62
| Facility | | $484.31 | $1,695.08 | $2,500.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.74 / $484.31 / $573.99
| Professional | | $358.74 | $484.31 | $573.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,079.59 / $2,771.17 / $8,459.92
| Facility | | $2,079.59 | $2,771.17 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.37 / $466.37 / $466.37
| Professional | | $466.37 | $466.37 | $466.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.30 / $777.28 / $1,748.88
| Facility | | $400.30 | $777.28 | $1,748.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.72 / $674.84 / $1,352.30
| Professional | | $314.72 | $674.84 | $1,352.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.04 / $478.33 / $1,010.47
| Professional | | $275.04 | $478.33 | $1,010.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.75 / $358.75 / $421.50
| Professional | | $358.75 | $358.75 | $421.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.22 / $1,695.08 / $2,469.37
| Facility | | $508.22 | $1,695.08 | $2,469.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.74 / $484.31 / $2,469.37
| Professional | | $358.74 | $484.31 | $2,469.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $884.91 / $896.87 / $1,195.82
| Professional | | $884.91 | $896.87 | $1,195.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $417.80 / $925.28 / $1,984.14
| Facility | | $417.80 | $925.28 | $1,984.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $443.30 / $674.84 / $1,352.30
| Professional | | $443.30 | $674.84 | $1,352.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.91 / $597.91 / $709.78
| Facility | | $597.91 | $597.91 | $709.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $597.91 / $597.91 / $709.78
| Professional | | $597.91 | $597.91 | $709.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.12 / $358.75 / $896.87
| Professional | | $251.12 | $358.75 | $896.87 |