- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.99 / $3,109.71 / $7,844.57
| Facility | | $287.99 | $3,109.71 | $7,844.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.77 / $377.18 / $779.29
| Professional | | $170.77 | $377.18 | $779.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.07 / $178.15 / $930.37
| Professional | | $89.07 | $178.15 | $930.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,704.83 / $1,704.83 / $1,729.70
| Facility | | $1,704.83 | $1,704.83 | $1,729.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.85 / $570.85 / $1,312.25
| Professional | | $277.85 | $570.85 | $1,312.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $273.24 / $511.48 / $1,103.33
| Professional | | $273.24 | $511.48 | $1,103.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.89 / $471.06 / $900.00
| Facility | | $175.89 | $471.06 | $900.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $370.00 / $677.00 / $692.85
| Professional | | $370.00 | $677.00 | $692.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.00 / $377.10 / $1,496.70
| Professional | | $3.00 | $377.10 | $1,496.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $444.62 / $625.74 / $1,153.56
| Professional | | $444.62 | $625.74 | $1,153.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $922.42 / $975.35 / $16,394.00
| Facility | | $922.42 | $975.35 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,792.20 / $2,614.19 / $3,173.36
| Professional | | $1,792.20 | $2,614.19 | $3,173.36 |