- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $239.88 / $371.54
| Facility | | $87.10 | $239.88 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $91.20 / $275.42
| Professional | | $72.44 | $91.20 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $8,511.38 / $77,624.71
| Facility | | $66.07 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $112.20 / $186.21
| Professional | | $107.15 | $112.20 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $190.55
| Facility | | $190.55 | $190.55 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.18 / $114.82 / $173.78
| Professional | | $69.18 | $114.82 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $128.82 / $177.83
| Professional | | $117.49 | $128.82 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $91.20 / $870.96
| Facility | | $91.20 | $91.20 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $89.13 / $154.88
| Professional | | $81.28 | $89.13 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $309.03 / $316.23
| Facility | | $281.84 | $309.03 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.10 / $239.88 / $371.54
| Facility | | $87.10 | $239.88 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $97.72 / $331.13
| Professional | | $75.86 | $97.72 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $478.63 / $478.63
| Facility | | $478.63 | $478.63 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $128.82 / $128.82
| Professional | | $120.23 | $128.82 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.65 / $58.88 / $128.82
| Facility | | $43.65 | $58.88 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $67.61 / $190.55
| Professional | | $31.62 | $67.61 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.79 / $102.33 / $177.83
| Professional | | $70.79 | $102.33 | $177.83 |