- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $745.64 / $845.06 / $994.19
| Facility | | $745.64 | $845.06 | $994.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.71 / $727.13 / $994.19
| Professional | | $30.71 | $727.13 | $994.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27.68 / $177.48 / $177.48
| Facility | | $27.68 | $177.48 | $177.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.44 / $1,082.10 / $2,825.57
| Professional | | $76.44 | $1,082.10 | $2,825.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.46 / $1,103.21 / $1,382.44
| Facility | | $40.46 | $1,103.21 | $1,382.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.63 / $1,099.79 / $1,974.01
| Professional | | $51.63 | $1,099.79 | $1,974.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46.61 / $46.61 / $46.61
| Facility | | $46.61 | $46.61 | $46.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $759.74 / $759.74 / $759.74
| Professional | | $759.74 | $759.74 | $759.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.78 / $34.78 / $44.33
| Facility | | $34.78 | $34.78 | $44.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,003.58 / $1,268.14 / $1,862.86
| Professional | | $1,003.58 | $1,268.14 | $1,862.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.07 / $679.71 / $2,324.51
| Professional | | $60.07 | $679.71 | $2,324.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.48 / $177.48 / $177.48
| Facility | | $177.48 | $177.48 | $177.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.74 / $1,220.08 / $5,042.20
| Professional | | $222.74 | $1,220.08 | $5,042.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $823.54 / $1,220.08 / $2,390.44
| Professional | | $823.54 | $1,220.08 | $2,390.44 |