- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $396.40 / $790.60 / $6,397.44
| Facility | | $396.40 | $790.60 | $6,397.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.51 / $396.40 / $520.79
| Professional | | $377.51 | $396.40 | $520.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.52 / $796.57 / $1,283.57
| Facility | | $377.52 | $796.57 | $1,283.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.52 / $377.52 / $377.52
| Professional | | $377.52 | $377.52 | $377.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.37 / $577.35 / $871.28
| Professional | | $507.37 | $577.35 | $871.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.15 / $356.15 / $377.52
| Facility | | $356.15 | $356.15 | $377.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.52 / $377.52 / $377.52
| Professional | | $377.52 | $377.52 | $377.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.89 / $438.37 / $453.02
| Professional | | $320.89 | $438.37 | $453.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.31 / $387.45 / $520.80
| Facility | | $186.31 | $387.45 | $520.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.00 / $246.00 / $246.00
| Professional | | $246.00 | $246.00 | $246.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.68 / $377.52 / $483.23
| Facility | | $354.68 | $377.52 | $483.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.68 / $377.52 / $483.23
| Professional | | $354.68 | $377.52 | $483.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.46 / $370.46 / $370.46
| Facility | | $370.46 | $370.46 | $370.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $377.52 / $400.17 / $445.47
| Professional | | $377.52 | $400.17 | $445.47 |