- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $386.75 / $513.08 / $733.10
| Facility | | $386.75 | $513.08 | $733.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.20 / $421.77 / $576.58
| Professional | | $360.20 | $421.77 | $576.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $317.20 / $396.52 / $723.76
| Professional | | $317.20 | $396.52 | $723.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.54 / $572.54 / $572.54
| Facility | | $572.54 | $572.54 | $572.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $572.54 / $572.54 / $584.01
| Professional | | $572.54 | $572.54 | $584.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.26 / $646.26 / $646.26
| Facility | | $646.26 | $646.26 | $646.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.93 / $605.13 / $1,384.58
| Professional | | $305.93 | $605.13 | $1,384.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.52 / $332.00 / $998.48
| Facility | | $163.52 | $332.00 | $998.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.48 / $553.28 / $828.01
| Professional | | $423.48 | $553.28 | $828.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.56 / $511.30 / $938.55
| Professional | | $315.56 | $511.30 | $938.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $466.99 / $466.99 / $472.13
| Professional | | $466.99 | $466.99 | $472.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $646.26 / $646.26
| Facility | | $555.00 | $646.26 | $646.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.77 / $595.86 / $1,330.11
| Professional | | $338.77 | $595.86 | $1,330.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $355.15 / $481.32 / $1,132.64
| Professional | | $355.15 | $481.32 | $1,132.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $468.51 / $468.51 / $575.22
| Facility | | $468.51 | $468.51 | $575.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.56 / $531.75 / $1,018.35
| Professional | | $315.56 | $531.75 | $1,018.35 |