- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.03 / $2,020.00 / $6,762.00
| Facility | | $135.03 | $2,020.00 | $6,762.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.58 / $78.84 / $156.87
| Professional | | $47.58 | $78.84 | $156.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.22 / $85.62 / $94.09
| Professional | | $52.22 | $85.62 | $94.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59.19 / $100.03 / $529.75
| Facility | | $59.19 | $100.03 | $529.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.43 / $93.24 / $158.11
| Professional | | $50.43 | $93.24 | $158.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.43 / $136.43 / $136.43
| Professional | | $136.43 | $136.43 | $136.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.46 / $170.05 / $170.05
| Facility | | $45.46 | $170.05 | $170.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.44 / $85.44 / $85.44
| Facility | | $85.44 | $85.44 | $85.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.43 / $119.52 / $234.08
| Professional | | $65.43 | $119.52 | $234.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $267.05
| Facility | | $55.00 | $55.00 | $267.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.52 / $724.40 / $846.83
| Professional | | $397.52 | $724.40 | $846.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.51 / $105.34 / $215.30
| Facility | | $53.51 | $105.34 | $215.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.38 / $107.46 / $170.96
| Professional | | $69.38 | $107.46 | $170.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.88 / $175.02 / $373.23
| Professional | | $83.88 | $175.02 | $373.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.60 / $107.27 / $223.81
| Facility | | $53.60 | $107.27 | $223.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.63 / $124.76 / $235.62
| Professional | | $66.63 | $124.76 | $235.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.00 / $950.00 / $2,376.00
| Facility | | $157.00 | $950.00 | $2,376.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.46 / $131.72 / $202.08
| Professional | | $90.46 | $131.72 | $202.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.38 / $94.09 / $132.12
| Professional | | $83.38 | $94.09 | $132.12 |