- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.82 / $339.71 / $914.92
| Professional | | $308.82 | $339.71 | $914.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $341.68 / $591.97 / $739.97
| Professional | | $341.68 | $591.97 | $739.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.44 / $499.28 / $684.01
| Facility | | $323.44 | $499.28 | $684.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $384.26 / $593.86 / $5,713.05
| Professional | | $384.26 | $593.86 | $5,713.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.69 / $640.16 / $673.24
| Facility | | $485.69 | $640.16 | $673.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $485.69 / $557.91 / $713.99
| Professional | | $485.69 | $557.91 | $713.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.52 / $567.97 / $743.34
| Professional | | $416.52 | $567.97 | $743.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $339.61 / $483.99 / $674.13
| Professional | | $339.61 | $483.99 | $674.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $672.40 / $692.50 / $692.50
| Professional | | $672.40 | $692.50 | $692.50 |