- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $635.12 / $703.85 / $806.39
| Facility | | $635.12 | $703.85 | $806.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $612.34 / $732.24 / $1,342.27
| Professional | | $612.34 | $732.24 | $1,342.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.96 / $842.96 / $842.96
| Facility | | $842.96 | $842.96 | $842.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $615.36 / $615.36 / $868.25
| Professional | | $615.36 | $615.36 | $868.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.88 / $99,999.99 / $99,999.99
| Facility | | $530.88 | $99,999.99 | $99,999.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $691.19 / $1,077.24 / $1,532.92
| Professional | | $691.19 | $1,077.24 | $1,532.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $541.56 / $833.17 / $916.48
| Professional | | $541.56 | $833.17 | $916.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $598.79 / $748.79 / $965.54
| Professional | | $598.79 | $748.79 | $965.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $833.17 / $833.17 / $833.17
| Professional | | $833.17 | $833.17 | $833.17 |