- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $265.22 / $270.26 / $941.51
| Facility | | $265.22 | $270.26 | $941.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.24 / $266.39 / $385.00
| Professional | | $232.24 | $266.39 | $385.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.41 / $357.13 / $1,072.75
| Professional | | $232.41 | $357.13 | $1,072.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $662.32 / $773.98 / $1,187.30
| Facility | | $662.32 | $773.98 | $1,187.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.29 / $624.98 / $899.33
| Professional | | $299.29 | $624.98 | $899.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.79 / $276.18 / $477.40
| Facility | | $234.79 | $276.18 | $477.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.52 / $276.24 / $477.40
| Facility | | $230.52 | $276.24 | $477.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.29 / $782.94 / $1,596.18
| Professional | | $327.29 | $782.94 | $1,596.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $137.91 / $222.86 / $480.99
| Professional | | $137.91 | $222.86 | $480.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.79 / $276.18 / $494.82
| Facility | | $234.79 | $276.18 | $494.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $327.51 / $589.23 / $838.20
| Professional | | $327.51 | $589.23 | $838.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.83 / $1,130.83 / $1,130.83
| Facility | | $1,130.83 | $1,130.83 | $1,130.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.44 / $1,284.50 / $1,596.18
| Professional | | $385.44 | $1,284.50 | $1,596.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.08 / $1,262.34 / $1,286.27
| Professional | | $537.08 | $1,262.34 | $1,286.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.27 / $515.26 / $963.38
| Professional | | $308.27 | $515.26 | $963.38 |