- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.89 / $350.20 / $1,034.55
| Facility | | $112.89 | $350.20 | $1,034.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.03 / $124.93 / $127.94
| Professional | | $82.03 | $124.93 | $127.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.47 / $287.55 / $614.00
| Facility | | $158.47 | $287.55 | $614.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $582.51 / $1,015.52 / $1,590.98
| Professional | | $582.51 | $1,015.52 | $1,590.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.40 / $198.69 / $1,350.16
| Facility | | $59.40 | $198.69 | $1,350.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.47 / $79.23 / $204.71
| Professional | | $55.47 | $79.23 | $204.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.54 / $204.44 / $408.09
| Facility | | $89.54 | $204.44 | $408.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.35 / $102.35 / $102.35
| Professional | | $102.35 | $102.35 | $102.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.53 / $121.91 / $164.58
| Professional | | $97.53 | $121.91 | $164.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.72 / $140.19 / $268.20
| Professional | | $109.72 | $140.19 | $268.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.12 / $579.07 / $579.07
| Facility | | $212.12 | $579.07 | $579.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $609.54 / $609.54 / $914.33
| Professional | | $609.54 | $609.54 | $914.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.32 / $184.31 / $369.26
| Facility | | $102.32 | $184.31 | $369.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.91 / $140.19 / $182.87
| Professional | | $121.91 | $140.19 | $182.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.91 / $121.91 / $121.91
| Professional | | $121.91 | $121.91 | $121.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.53 / $109.72 / $165.80
| Professional | | $97.53 | $109.72 | $165.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.20 / $63.22 / $270.32
| Professional | | $51.20 | $63.22 | $270.32 |