- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $328.89 / $2,124.00 / $7,513.00
| Facility | | $328.89 | $2,124.00 | $7,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.75 / $234.18 / $382.93
| Professional | | $146.75 | $234.18 | $382.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.97 / $243.06 / $991.68
| Facility | | $140.97 | $243.06 | $991.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.13 / $233.93 / $323.76
| Professional | | $149.13 | $233.93 | $323.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $141.12 / $141.68
| Facility | | $80.00 | $141.12 | $141.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.31 / $270.31 / $270.31
| Facility | | $270.31 | $270.31 | $270.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.77 / $268.97 / $435.50
| Professional | | $173.77 | $268.97 | $435.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $811.06
| Facility | | $55.00 | $55.00 | $811.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,168.96 / $1,794.08 / $2,087.63
| Professional | | $1,168.96 | $1,794.08 | $2,087.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.94 / $243.68 / $382.84
| Facility | | $160.94 | $243.68 | $382.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.53 / $291.20 / $434.34
| Professional | | $203.53 | $291.20 | $434.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.72 / $308.49 / $598.44
| Professional | | $183.72 | $308.49 | $598.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.07 / $244.46 / $390.15
| Facility | | $161.07 | $244.46 | $390.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.08 / $288.52 / $471.61
| Professional | | $177.08 | $288.52 | $471.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $374.00 / $1,529.00 / $3,400.00
| Facility | | $374.00 | $1,529.00 | $3,400.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.18 / $256.24 / $404.18
| Professional | | $192.18 | $256.24 | $404.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.94 / $232.08 / $326.81
| Professional | | $205.94 | $232.08 | $326.81 |