- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $484.31 / $1,697.45 / $2,500.62
| Facility | | $484.31 | $1,697.45 | $2,500.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $448.43 / $484.31 / $719.07
| Professional | | $448.43 | $484.31 | $719.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,065.12 / $2,751.88 / $8,459.92
| Facility | | $2,065.12 | $2,751.88 | $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 / $796.21 / $1,984.14
| Facility | | $400.30 | $796.21 | $1,984.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $314.72 / $640.04 / $895.90
| Professional | | $314.72 | $640.04 | $895.90 |
- 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
- Facility
- Modifier
- Low / Median / High Price
- $763.35 / $1,204.13 / $1,627.75
| Facility | | $763.35 | $1,204.13 | $1,627.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $390.13 / $390.13 / $421.50
| Professional | | $390.13 | $390.13 | $421.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.22 / $1,625.84 / $2,469.37
| Facility | | $508.22 | $1,625.84 | $2,469.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.45 / $490.29 / $2,469.37
| Professional | | $442.45 | $490.29 | $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 / $994.72 / $1,984.14
| Facility | | $417.80 | $994.72 | $1,984.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.75 / $674.84 / $1,352.30
| Professional | | $358.75 | $674.84 | $1,352.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.91 / $597.91 / $657.70
| Facility | | $597.91 | $597.91 | $657.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $597.91 / $597.91 / $657.70
| Professional | | $597.91 | $597.91 | $657.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.42 / $358.75 / $798.33
| Professional | | $61.42 | $358.75 | $798.33 |