- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,548.82 / $2,511.89
| Facility | | $524.81 | $1,548.82 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $309.03 / $426.58
| Professional | | $245.47 | $309.03 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $954.99 / $954.99
| Facility | | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $281.84 / $676.08
| Professional | | $194.98 | $281.84 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $851.14 / $1,047.13
| Facility | | $269.15 | $851.14 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $295.12 / $741.31
| Professional | | $218.78 | $295.12 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $630.96 / $1,258.93
| Facility | | $251.19 | $630.96 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $416.87 / $501.19
| Professional | | $371.54 | $416.87 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.84 / $416.87 / $660.69
| Professional | | $338.84 | $416.87 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $1,778.28 / $1,778.28
| Facility | | $1,778.28 | $1,778.28 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,818.38 / $2,818.38
| Professional | | $1,862.09 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $446.68 / $977.24
| Facility | | $295.12 | $446.68 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $416.87 / $537.03
| Professional | | $371.54 | $416.87 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $371.54
| Professional | | $371.54 | $371.54 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.49 / $158.49 / $724.44
| Professional | | $158.49 | $158.49 | $724.44 |