- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,513.56 / $2,454.71
| Facility | | $616.60 | $1,513.56 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.05 / $478.63 / $1,071.52
| Professional | | $389.05 | $478.63 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,467.37 / $5,011.87
| Facility | | $2,630.27 | $3,467.37 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $1,174.90
| Professional | | $457.09 | $457.09 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $954.99 / $1,995.26
| Facility | | $575.44 | $954.99 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $562.34 / $1,258.93
| Professional | | $309.03 | $562.34 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $758.58 / $1,122.02
| Professional | | $407.38 | $758.58 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $588.84
| Facility | | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $776.25 / $1,288.25
| Professional | | $537.03 | $776.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $1,995.26
| Facility | | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,479.11 / $2,454.71
| Facility | | $549.54 | $1,479.11 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $549.54 / $2,398.83
| Professional | | $407.38 | $549.54 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $831.76
| Professional | | $831.76 | $831.76 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $794.33
| Facility | | $446.68 | $478.63 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $602.56
| Professional | | $446.68 | $478.63 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $588.84 / $707.95
| Facility | | $588.84 | $588.84 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $354.81 / $812.83
| Professional | | $245.47 | $354.81 | $812.83 |