- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $954.99 / $1,513.56
| Facility | | $426.58 | $954.99 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $380.19 / $489.78
| Professional | | $275.42 | $380.19 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $28.84 / $389.05
| Professional | | $28.84 | $28.84 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $501.19 / $501.19
| Professional | | $371.54 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,071.52 / $1,288.25
| Facility | | $323.59 | $1,071.52 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.44 / $2,398.83 / $2,398.83
| Professional | | $575.44 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $831.76 / $1,949.84
| Facility | | $501.19 | $831.76 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $302.00 / $977.24
| Professional | | $234.42 | $302.00 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $501.19 / $575.44
| Professional | | $316.23 | $501.19 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $954.99 / $50,118.72
| Facility | | $660.69 | $954.99 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $457.09 / $602.56
| Facility | | $302.00 | $457.09 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $302.00 / $758.58
| Professional | | $213.80 | $302.00 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $501.19 / $575.44
| Facility | | $302.00 | $501.19 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $501.19 / $575.44
| Professional | | $302.00 | $501.19 | $575.44 |