- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.26 / $1,481.72 / $1,953.24
| Facility | | $354.26 | $1,481.72 | $1,953.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.42 / $352.01 / $2,168.80
| Professional | | $308.42 | $352.01 | $2,168.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,974.66 / $2,631.34 / $8,459.92
| Facility | | $1,974.66 | $2,631.34 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.08 / $325.08 / $325.08
| Professional | | $325.08 | $325.08 | $325.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.53 / $615.77 / $1,383.25
| Facility | | $395.53 | $615.77 | $1,383.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.93 / $400.67 / $942.76
| Professional | | $244.93 | $400.67 | $942.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.99 / $562.65 / $791.88
| Professional | | $247.99 | $562.65 | $791.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.37 / $1,134.64 / $1,773.61
| Facility | | $337.37 | $1,134.64 | $1,773.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.26 / $1,141.05 / $1,881.85
| Facility | | $354.26 | $1,141.05 | $1,881.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.58 / $479.30 / $2,168.80
| Professional | | $312.58 | $479.30 | $2,168.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $616.83 / $625.16 / $833.56
| Professional | | $616.83 | $625.16 | $833.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.52 / $693.39 / $1,383.25
| Facility | | $405.52 | $693.39 | $1,383.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $247.42 / $445.16 / $942.76
| Professional | | $247.42 | $445.16 | $942.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.78 / $416.78 / $628.89
| Facility | | $416.78 | $416.78 | $628.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.78 / $416.78 / $628.89
| Professional | | $416.78 | $416.78 | $628.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.05 / $250.07 / $660.86
| Professional | | $175.05 | $250.07 | $660.86 |