- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.01 / $429.26 / $437.52
| Facility | | $421.01 | $429.26 | $437.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $396.24 / $437.52 / $670.73
| Professional | | $396.24 | $437.52 | $670.73 |
- 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
- $448.66 / $448.66 / $448.66
| Professional | | $448.66 | $448.66 | $448.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $942.75 / $942.75 / $942.75
| Facility | | $942.75 | $942.75 | $942.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.80 / $550.80 / $550.80
| Facility | | $550.80 | $550.80 | $550.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.09 / $402.09 / $550.80
| Professional | | $402.09 | $402.09 | $550.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,927.87 / $4,148.45 / $4,851.27
| Facility | | $1,927.87 | $4,148.45 | $4,851.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5,915.12 / $6,057.09 / $7,370.85
| Professional | | $5,915.12 | $6,057.09 | $7,370.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.70 / $652.28 / $942.75
| Facility | | $246.70 | $652.28 | $942.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $246.70 / $789.56 / $942.75
| Professional | | $246.70 | $789.56 | $942.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.10 / $942.75 / $2,163.62
| Professional | | $310.10 | $942.75 | $2,163.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $246.70 / $629.90 / $942.75
| Facility | | $246.70 | $629.90 | $942.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $402.09 / $402.09 / $567.33
| Professional | | $402.09 | $402.09 | $567.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $318.45 / $460.51 / $548.23
| Professional | | $318.45 | $460.51 | $548.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $458.91 / $466.53 / $942.75
| Professional | | $458.91 | $466.53 | $942.75 |