- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $357.10 / $448.78 / $1,806.27
| Professional | | $357.10 | $448.78 | $1,806.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $313.16 / $405.26 / $749.51
| Professional | | $313.16 | $405.26 | $749.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.76 / $673.50 / $1,268.42
| Professional | | $397.76 | $673.50 | $1,268.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.42 / $486.90 / $1,148.06
| Professional | | $325.42 | $486.90 | $1,148.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.38 / $310.38 / $402.85
| Professional | | $310.38 | $310.38 | $402.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.22 / $477.16 / $644.16
| Professional | | $333.22 | $477.16 | $644.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.81 / $477.16 / $897.06
| Professional | | $361.81 | $477.16 | $897.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,349.37 / $2,349.37 / $2,956.28
| Professional | | $2,349.37 | $2,349.37 | $2,956.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.38 / $310.38 / $805.47
| Professional | | $310.38 | $310.38 | $805.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,229.42 / $1,229.42 / $1,229.42
| Professional | | $1,229.42 | $1,229.42 | $1,229.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $385.99 / $466.51 / $566.47
| Professional | | $385.99 | $466.51 | $566.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $383.02 / $466.93 / $1,137.79
| Professional | | $383.02 | $466.93 | $1,137.79 |