- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.90 / $228.29 / $232.68
| Facility | | $223.90 | $228.29 | $232.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.11 / $232.68 / $377.55
| Professional | | $215.11 | $232.68 | $377.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,456.92 / $5,821.21 / $8,577.84
| Facility | | $5,456.92 | $5,821.21 | $8,577.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $238.60 / $238.60 / $298.52
| Professional | | $238.60 | $238.60 | $298.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.43 / $369.43 / $501.36
| Facility | | $369.43 | $369.43 | $501.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.02 / $297.02 / $297.02
| Facility | | $297.02 | $297.02 | $297.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.82 / $216.82 / $297.02
| Professional | | $216.82 | $216.82 | $297.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $990.23 / $2,464.07 / $2,885.01
| Facility | | $990.23 | $2,464.07 | $2,885.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,915.38 / $2,942.33 / $4,091.55
| Professional | | $2,915.38 | $2,942.33 | $4,091.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.71 / $346.89 / $501.36
| Facility | | $146.71 | $346.89 | $501.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.71 / $451.22 / $543.75
| Professional | | $146.71 | $451.22 | $543.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $526.42 / $526.42 / $536.96
| Professional | | $526.42 | $526.42 | $536.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.71 / $335.00 / $501.36
| Facility | | $146.71 | $335.00 | $501.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.82 / $216.82 / $415.41
| Professional | | $216.82 | $216.82 | $415.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $189.39 / $273.87 / $326.02
| Professional | | $189.39 | $273.87 | $326.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $272.91 / $276.35 / $501.36
| Professional | | $272.91 | $276.35 | $501.36 |