- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.83 / $817.08 / $1,545.10
| Facility | | $218.83 | $817.08 | $1,545.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.22 / $211.11 / $1,655.40
| Professional | | $199.22 | $211.11 | $1,655.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,298.25 / $1,729.99 / $8,459.92
| Facility | | $1,298.25 | $1,729.99 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.81 / $200.81 / $200.81
| Professional | | $200.81 | $200.81 | $200.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.32 / $391.08 / $854.07
| Facility | | $244.32 | $391.08 | $854.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.68 / $247.39 / $582.10
| Professional | | $150.68 | $247.39 | $582.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.19 / $347.56 / $489.16
| Professional | | $153.19 | $347.56 | $489.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.13 / $680.92 / $1,304.27
| Facility | | $336.13 | $680.92 | $1,304.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.95 / $700.06 / $1,419.60
| Facility | | $218.95 | $700.06 | $1,419.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.09 / $296.07 / $1,063.27
| Professional | | $193.09 | $296.07 | $1,063.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.80 / $362.30 / $427.50
| Professional | | $289.80 | $362.30 | $427.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.62 / $428.31 / $854.07
| Facility | | $250.62 | $428.31 | $854.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.53 / $275.06 / $582.10
| Professional | | $161.53 | $275.06 | $582.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.45 / $257.45 / $257.45
| Facility | | $257.45 | $257.45 | $257.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.45 / $257.45 / $262.60
| Professional | | $257.45 | $257.45 | $262.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.13 / $159.12 / $471.13
| Professional | | $108.13 | $159.12 | $471.13 |