- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.70 / $485.44 / $485.44
| Facility | | $435.70 | $485.44 | $485.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $435.70 / $500.96 / $724.61
| Professional | | $435.70 | $500.96 | $724.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.84 / $600.84 / $2,719.23
| Facility | | $600.84 | $600.84 | $2,719.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $447.29 / $609.29 / $1,136.11
| Professional | | $447.29 | $609.29 | $1,136.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.17 / $501.62 / $1,121.63
| Professional | | $342.17 | $501.62 | $1,121.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $591.85 / $591.85 / $591.85
| Facility | | $591.85 | $591.85 | $591.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.53 / $608.99 / $1,252.96
| Professional | | $471.53 | $608.99 | $1,252.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.50 / $578.47 / $780.93
| Professional | | $381.50 | $578.47 | $780.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $471.92 / $588.86 / $1,365.09
| Professional | | $471.92 | $588.86 | $1,365.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,196.65 / $2,337.33 / $2,542.82
| Facility | | $1,196.65 | $2,337.33 | $2,542.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,266.93 / $3,786.99 / $4,193.63
| Professional | | $3,266.93 | $3,786.99 | $4,193.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.44 / $631.21 / $896.35
| Facility | | $485.44 | $631.21 | $896.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.85 / $678.80 / $1,307.69
| Professional | | $480.85 | $678.80 | $1,307.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,548.34 / $1,548.34 / $1,548.34
| Professional | | $1,548.34 | $1,548.34 | $1,548.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $367.57 / $487.93 / $974.93
| Professional | | $367.57 | $487.93 | $974.93 |