- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $741.31 / $3,388.44
| Facility | | $151.36 | $741.31 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $194.98 / $512.86
| Professional | | $128.82 | $194.98 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $251.19 / $1,548.82
| Facility | | $229.09 | $251.19 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $239.88 / $1,202.26
| Professional | | $107.15 | $239.88 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $316.23 / $776.25
| Facility | | $257.04 | $316.23 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $407.38 / $954.99
| Facility | | $151.36 | $407.38 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $371.54 / $588.84
| Professional | | $204.17 | $371.54 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $524.81 / $7,079.46
| Facility | | $109.65 | $524.81 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $371.54 / $489.78 / $724.44
| Professional | | $371.54 | $489.78 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $436.52 / $831.76
| Professional | | $323.59 | $436.52 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,096.48 / $1,513.56
| Facility | | $489.78 | $1,096.48 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $251.19 / $1,548.82
| Facility | | $229.09 | $251.19 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $239.88 / $1,202.26
| Professional | | $107.15 | $239.88 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $831.76 / $1,445.44
| Facility | | $97.72 | $831.76 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.15 / $281.84 / $741.31
| Professional | | $107.15 | $281.84 | $741.31 |