- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $436.52 / $1,380.38
| Facility | | $181.97 | $436.52 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $229.09 / $331.13
| Professional | | $181.97 | $229.09 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $295.12 / $1,348.96
| Facility | | $194.98 | $295.12 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $436.52
| Professional | | $371.54 | $371.54 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $1,445.44
| Facility | | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,238.72 / $2,238.72
| Professional | | $1,513.56 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $302.00 / $562.34
| Facility | | $208.93 | $302.00 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $239.88 / $363.08
| Professional | | $181.97 | $239.88 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $323.59 / $645.65
| Professional | | $302.00 | $323.59 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $302.00 / $831.76
| Facility | | $208.93 | $302.00 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $316.23 / $524.81
| Professional | | $79.43 | $316.23 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $125.89 / $302.00
| Facility | | $109.65 | $125.89 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $125.89 / $208.93
| Professional | | $125.89 | $125.89 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $302.00 / $302.00
| Professional | | $117.49 | $302.00 | $302.00 |