- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $434.11 / $836.20 / $1,854.25
| Facility | | $434.11 | $836.20 | $1,854.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.68 / $521.53 / $521.53
| Professional | | $313.68 | $521.53 | $521.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.14 / $725.49 / $1,474.68
| Facility | | $275.14 | $725.49 | $1,474.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.92 / $329.92 / $329.92
| Professional | | $329.92 | $329.92 | $329.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.02 / $392.10 / $1,218.89
| Facility | | $312.02 | $392.10 | $1,218.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.72 / $338.72 / $338.72
| Facility | | $338.72 | $338.72 | $338.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.92 / $486.76 / $486.76
| Facility | | $295.92 | $486.76 | $486.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.00 / $486.76 / $486.76
| Professional | | $209.00 | $486.76 | $486.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.30 / $1,568.40 / $1,588.35
| Facility | | $443.30 | $1,568.40 | $1,588.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.57 / $521.53 / $1,109.42
| Facility | | $202.57 | $521.53 | $1,109.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.50 / $296.50 / $313.68
| Professional | | $296.50 | $296.50 | $313.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $273.55 / $486.76 / $521.53
| Facility | | $273.55 | $486.76 | $521.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.50 / $486.76 / $486.76
| Professional | | $296.50 | $486.76 | $486.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.71 / $355.71 / $421.24
| Facility | | $355.71 | $355.71 | $421.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.85 / $402.25 / $529.09
| Professional | | $323.85 | $402.25 | $529.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.68 / $422.19 / $423.47
| Professional | | $313.68 | $422.19 | $423.47 |