- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.22 / $852.37 / $1,191.44
| Facility | | $803.22 | $852.37 | $1,191.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $708.18 / $923.70 / $1,191.44
| Professional | | $708.18 | $923.70 | $1,191.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.11 / $226.83 / $457.84
| Facility | | $114.11 | $226.83 | $457.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.98 / $79.98 / $79.98
| Professional | | $79.98 | $79.98 | $79.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,397.90 / $1,397.90 / $1,397.90
| Facility | | $1,397.90 | $1,397.90 | $1,397.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $881.10 / $881.10 / $1,167.58
| Facility | | $881.10 | $881.10 | $1,167.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $748.94 / $881.10 / $881.10
| Professional | | $748.94 | $881.10 | $881.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,452.79 / $6,756.10 / $7,002.40
| Facility | | $2,452.79 | $6,756.10 | $7,002.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.82 / $628.07 / $1,289.21
| Facility | | $118.82 | $628.07 | $1,289.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.61 / $154.76 / $1,406.59
| Professional | | $128.61 | $154.76 | $1,406.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.87 / $628.07 / $1,191.44
| Facility | | $133.87 | $628.07 | $1,191.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.87 / $881.10 / $881.10
| Professional | | $109.87 | $881.10 | $881.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $665.04 / $784.37 / $1,265.25
| Professional | | $665.04 | $784.37 | $1,265.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $976.66 / $1,018.78 / $1,018.78
| Professional | | $976.66 | $1,018.78 | $1,018.78 |