- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.51 / $601.95 / $1,017.52
| Facility | | $505.51 | $601.95 | $1,017.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.76 / $513.85 / $1,063.08
| Professional | | $508.76 | $513.85 | $1,063.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.96 / $686.21 / $969.76
| Facility | | $479.96 | $686.21 | $969.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.76 / $508.76 / $551.95
| Professional | | $508.76 | $508.76 | $551.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $498.50 / $1,110.07 / $1,285.91
| Professional | | $498.50 | $1,110.07 | $1,285.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.96 / $647.05 / $1,093.83
| Facility | | $480.96 | $647.05 | $1,093.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.76 / $539.28 / $635.95
| Professional | | $508.76 | $539.28 | $635.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.50 / $631.89 / $1,058.22
| Facility | | $505.50 | $631.89 | $1,058.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $480.51 / $525.91 / $727.53
| Facility | | $480.51 | $525.91 | $727.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $406.38 / $551.95 / $606.15
| Professional | | $406.38 | $551.95 | $606.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.43 / $517.21 / $1,046.47
| Facility | | $432.43 | $517.21 | $1,046.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.76 / $508.76 / $508.76
| Professional | | $508.76 | $508.76 | $508.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $508.76 / $508.76 / $508.76
| Professional | | $508.76 | $508.76 | $508.76 |