- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.51 / $275.70 / $349.96
| Facility | | $82.51 | $275.70 | $349.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.51 / $102.35 / $330.03
| Professional | | $82.51 | $102.35 | $330.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.00 / $266.45 / $818.35
| Facility | | $121.00 | $266.45 | $818.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.01 / $145.04 / $1,846.00
| Professional | | $98.01 | $145.04 | $1,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.05 / $310.61 / $530.87
| Facility | | $192.05 | $310.61 | $530.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.90 / $212.15 / $281.91
| Professional | | $126.90 | $212.15 | $281.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.87 / $422.40 / $474.39
| Facility | | $130.87 | $422.40 | $474.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.64 / $208.00 / $340.44
| Professional | | $122.64 | $208.00 | $340.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.78 / $231.40 / $6,679.00
| Facility | | $110.78 | $231.40 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.63 / $157.47 / $234.45
| Professional | | $124.63 | $157.47 | $234.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.35 / $248.14 / $342.46
| Professional | | $134.35 | $248.14 | $342.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.50 / $157.50 / $157.50
| Professional | | $157.50 | $157.50 | $157.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.53 / $544.97 / $544.97
| Facility | | $251.53 | $544.97 | $544.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.98 / $159.88 / $1,846.00
| Professional | | $109.98 | $159.88 | $1,846.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.98 / $147.32 / $297.58
| Professional | | $109.98 | $147.32 | $297.58 |