- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.65 / $358.17 / $721.24
| Facility | | $344.65 | $358.17 | $721.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.90 / $358.17 / $581.17
| Professional | | $337.90 | $358.17 | $581.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.84 / $459.84 / $459.84
| Professional | | $459.84 | $459.84 | $459.84 |
- 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
- $367.29 / $367.29 / $459.54
| Professional | | $367.29 | $367.29 | $459.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.77 / $771.77 / $771.77
| Facility | | $771.77 | $771.77 | $771.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.53 / $488.53 / $488.53
| Facility | | $488.53 | $488.53 | $488.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.63 / $356.63 / $661.20
| Professional | | $356.63 | $356.63 | $661.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,665.78 / $4,287.21 / $4,287.21
| Facility | | $1,665.78 | $4,287.21 | $4,287.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4,332.34 / $4,332.34 / $6,185.25
| Professional | | $4,332.34 | $4,332.34 | $6,185.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.26 / $580.00 / $944.47
| Facility | | $232.26 | $580.00 | $944.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.26 / $694.59 / $791.26
| Professional | | $232.26 | $694.59 | $791.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.10 / $708.49 / $1,771.22
| Professional | | $295.10 | $708.49 | $1,771.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.26 / $502.52 / $902.57
| Facility | | $232.26 | $502.52 | $902.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.63 / $488.53 / $666.16
| Professional | | $356.63 | $488.53 | $666.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $299.81 / $443.51 / $555.96
| Professional | | $299.81 | $443.51 | $555.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.06 / $439.23 / $771.77
| Professional | | $432.06 | $439.23 | $771.77 |