- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.24 / $297.51 / $388.01
| Facility | | $133.24 | $297.51 | $388.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.56 / $133.24 / $133.24
| Professional | | $117.56 | $133.24 | $133.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $595.34 / $763.37 / $964.01
| Facility | | $595.34 | $763.37 | $964.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.28 / $13.28 / $22.16
| Professional | | $13.28 | $13.28 | $22.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.40 / $125.40 / $244.53
| Professional | | $125.40 | $125.40 | $244.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.89 / $345.73 / $803.52
| Facility | | $101.89 | $345.73 | $803.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.31 / $191.31 / $229.21
| Professional | | $191.31 | $191.31 | $229.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.75 / $188.10 / $231.99
| Professional | | $156.75 | $188.10 | $231.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.61 / $156.75 / $266.48
| Facility | | $124.61 | $156.75 | $266.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $215.00 / $310.37 / $376.20
| Professional | | $215.00 | $310.37 | $376.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.73 / $173.96 / $291.02
| Facility | | $109.73 | $173.96 | $291.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.73 / $178.22 / $291.02
| Professional | | $109.73 | $178.22 | $291.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.10 / $188.10 / $188.10
| Facility | | $188.10 | $188.10 | $188.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.84 / $78.38 / $180.26
| Professional | | $65.84 | $78.38 | $180.26 |