- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.75 / $706.09 / $14,464.32
| Facility | | $239.75 | $706.09 | $14,464.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.99 / $329.92 / $773.62
| Professional | | $164.99 | $329.92 | $773.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.68 / $5,700.71 / $26,542.00
| Facility | | $412.68 | $5,700.71 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.31 / $564.94 / $2,421.96
| Professional | | $241.31 | $564.94 | $2,421.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $210.86 / $394.60 / $903.66
| Professional | | $210.86 | $394.60 | $903.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.64 / $387.99 / $868.90
| Facility | | $213.64 | $387.99 | $868.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.64 / $388.65 / $856.84
| Professional | | $213.64 | $388.65 | $856.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.49 / $514.21 / $853.00
| Professional | | $84.49 | $514.21 | $853.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.60 / $578.03 / $697.58
| Facility | | $287.60 | $578.03 | $697.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.39 / $410.39 / $412.68
| Facility | | $410.39 | $410.39 | $412.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.57 / $404.91 / $746.24
| Professional | | $237.57 | $404.91 | $746.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,524.92 / $4,524.92 / $5,700.71
| Facility | | $4,524.92 | $4,524.92 | $5,700.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.58 / $390.43 / $695.05
| Professional | | $203.58 | $390.43 | $695.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.00 / $1,078.00 / $6,216.00
| Facility | | $497.00 | $1,078.00 | $6,216.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.35 / $575.36 / $890.88
| Professional | | $397.35 | $575.36 | $890.88 |