- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.88 / $286.27 / $470.05
| Facility | | $95.88 | $286.27 | $470.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.13 / $133.59 / $564.20
| Professional | | $102.13 | $133.59 | $564.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.47 / $451.37 / $843.41
| Facility | | $149.47 | $451.37 | $843.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.18 / $234.31 / $1,024.30
| Professional | | $143.18 | $234.31 | $1,024.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.19 / $357.70 / $664.38
| Facility | | $332.19 | $357.70 | $664.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.51 / $189.61 / $412.82
| Facility | | $133.51 | $189.61 | $412.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.11 / $249.36 / $507.92
| Professional | | $152.11 | $249.36 | $507.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.94 / $156.13 / $257.73
| Professional | | $62.94 | $156.13 | $257.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.92 / $447.94 / $593.41
| Professional | | $226.92 | $447.94 | $593.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.67 / $125.00 / $285.57
| Facility | | $33.67 | $125.00 | $285.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.65 / $114.69 / $147.07
| Professional | | $31.65 | $114.69 | $147.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.61 / $843.41 / $843.41
| Facility | | $338.61 | $843.41 | $843.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.10 / $231.15 / $1,024.30
| Professional | | $151.10 | $231.15 | $1,024.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.08 / $209.45 / $275.69
| Facility | | $177.08 | $209.45 | $275.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.00 / $189.00 / $748.64
| Professional | | $111.00 | $189.00 | $748.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.55 / $209.92 / $410.61
| Professional | | $149.55 | $209.92 | $410.61 |