- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.52 / $380.85 / $388.17
| Facility | | $373.52 | $380.85 | $388.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.88 / $388.17 / $625.16
| Professional | | $358.88 | $388.17 | $625.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.06 / $398.06 / $498.03
| Professional | | $398.06 | $398.06 | $498.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $836.42 / $836.42 / $836.42
| Facility | | $836.42 | $836.42 | $836.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.57 / $450.57 / $450.57
| Facility | | $450.57 | $450.57 | $450.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.92 / $328.92 / $450.57
| Professional | | $328.92 | $328.92 | $450.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,944.44 / $3,794.31 / $4,566.79
| Facility | | $1,944.44 | $3,794.31 | $4,566.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6,147.14 / $6,294.65 / $7,210.73
| Professional | | $6,147.14 | $6,294.65 | $7,210.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.24 / $582.91 / $836.42
| Facility | | $232.24 | $582.91 | $836.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.24 / $769.51 / $861.28
| Professional | | $232.24 | $769.51 | $861.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $767.84 / $853.15 / $1,919.59
| Professional | | $767.84 | $853.15 | $1,919.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.24 / $558.89 / $836.42
| Facility | | $232.24 | $558.89 | $836.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $328.92 / $328.92 / $480.33
| Professional | | $328.92 | $328.92 | $480.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.77 / $433.51 / $516.08
| Professional | | $299.77 | $433.51 | $516.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.00 / $463.84 / $836.42
| Professional | | $432.00 | $463.84 | $836.42 |