- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.22 / $336.44 / $428.05
| Facility | | $281.22 | $336.44 | $428.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.02 / $374.21 / $485.64
| Professional | | $311.02 | $374.21 | $485.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $345.20 / $345.20 / $345.20
| Professional | | $345.20 | $345.20 | $345.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.06 / $696.02 / $1,285.75
| Facility | | $291.06 | $696.02 | $1,285.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.53 / $302.66 / $356.07
| Professional | | $60.53 | $302.66 | $356.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.50 / $268.01 / $359.38
| Facility | | $230.50 | $268.01 | $359.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $342.02 / $472.47 / $724.32
| Professional | | $342.02 | $472.47 | $724.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.09 / $2,064.73 / $2,064.73
| Facility | | $826.09 | $2,064.73 | $2,064.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,332.12 / $2,332.12 / $3,329.85
| Professional | | $2,332.12 | $2,332.12 | $3,329.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $335.56 / $402.26 / $560.52
| Facility | | $335.56 | $402.26 | $560.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.97 / $370.97 / $431.17
| Professional | | $370.97 | $370.97 | $431.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.32 / $159.86 / $261.87
| Professional | | $135.32 | $159.86 | $261.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.96 / $392.55 / $582.08
| Facility | | $330.96 | $392.55 | $582.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.89 / $489.00 / $724.32
| Professional | | $364.89 | $489.00 | $724.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.64 / $415.01 / $671.93
| Professional | | $313.64 | $415.01 | $671.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $431.17 / $538.96 / $582.08
| Professional | | $431.17 | $538.96 | $582.08 |