- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,890.45 / $8,317.64
| Facility | | $954.99 | $3,890.45 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $281.84 / $676.08
| Professional | | $194.98 | $281.84 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $302.00
| Professional | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $316.23 / $562.34
| Professional | | $213.80 | $316.23 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $446.68 / $489.78
| Professional | | $354.81 | $446.68 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.09 / $354.81 / $537.03
| Professional | | $229.09 | $354.81 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,818.38 / $8,317.64
| Facility | | $912.01 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $331.13 / $870.96
| Professional | | $204.17 | $331.13 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $602.56
| Facility | | $275.42 | $275.42 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.04 / $562.34 / $851.14
| Professional | | $257.04 | $562.34 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $346.74 / $416.87
| Facility | | $190.55 | $346.74 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $295.12 / $416.87
| Professional | | $162.18 | $295.12 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $1,148.15 / $3,890.45
| Facility | | $223.87 | $1,148.15 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $295.12 / $501.19
| Professional | | $194.98 | $295.12 | $501.19 |