- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $512.86 / $977.24
| Facility | | $186.21 | $512.86 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $186.21 / $234.42
| Professional | | $165.96 | $186.21 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $977.24
| Facility | | $245.47 | $245.47 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $45.71 / $147.91
| Professional | | $45.71 | $45.71 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $478.63 / $1,122.02
| Facility | | $173.78 | $478.63 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $281.84 / $354.81
| Professional | | $102.33 | $281.84 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $295.12 / $363.08
| Professional | | $245.47 | $295.12 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $204.17 / $302.00
| Facility | | $162.18 | $204.17 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $512.86
| Professional | | $204.17 | $204.17 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $309.03 / $1,023.29
| Facility | | $162.18 | $309.03 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $309.03 / $1,023.29
| Professional | | $162.18 | $309.03 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $245.47 / $295.12
| Facility | | $104.71 | $245.47 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $112.20 / $186.21
| Professional | | $104.71 | $112.20 | $186.21 |