- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $524.81 / $831.76
| Facility | | $234.42 | $524.81 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $218.78 / $302.00
| Professional | | $162.18 | $218.78 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $512.86
| Professional | | $229.09 | $229.09 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $275.42
| Facility | | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $275.42 / $275.42
| Professional | | $199.53 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $588.84 / $707.95
| Facility | | $177.83 | $588.84 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $1,318.26 / $1,318.26
| Professional | | $275.42 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $457.09 / $1,047.13
| Facility | | $275.42 | $457.09 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.40 / $363.08 / $537.03
| Professional | | $288.40 | $363.08 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $269.15 / $489.78
| Professional | | $229.09 | $269.15 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $512.86 / $50,118.72
| Facility | | $354.81 | $512.86 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $281.84
| Professional | | $275.42 | $275.42 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $275.42 / $331.13
| Facility | | $245.47 | $275.42 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $165.96 / $363.08
| Professional | | $114.82 | $165.96 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $275.42 / $316.23
| Facility | | $165.96 | $275.42 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $275.42 / $549.54
| Professional | | $229.09 | $275.42 | $549.54 |