- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.48 / $407.48 / $416.38
| Facility | | $407.48 | $407.48 | $416.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $362.41 / $422.50 / $564.79
| Professional | | $362.41 | $422.50 | $564.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.35 / $972.76 / $1,965.12
| Facility | | $818.35 | $972.76 | $1,965.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.31 / $744.17 / $2,505.33
| Professional | | $377.31 | $744.17 | $2,505.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $576.36 / $1,026.18 / $1,344.70
| Facility | | $576.36 | $1,026.18 | $1,344.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $442.14 / $741.96 / $1,185.10
| Professional | | $442.14 | $741.96 | $1,185.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $401.37 / $836.06 / $6,679.00
| Facility | | $401.37 | $836.06 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $244.98 / $460.61 / $742.59
| Professional | | $244.98 | $460.61 | $742.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $488.65 / $944.84 / $1,240.49
| Professional | | $488.65 | $944.84 | $1,240.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $603.52 / $625.13 / $641.00
| Professional | | $603.52 | $625.13 | $641.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.12 / $1,965.12 / $1,965.12
| Facility | | $1,965.12 | $1,965.12 | $1,965.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $462.62 / $823.47 / $10,080.00
| Professional | | $462.62 | $823.47 | $10,080.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $426.94 / $619.19 / $1,536.54
| Professional | | $426.94 | $619.19 | $1,536.54 |