- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.44 / $224.91 / $2,361.23
| Facility | | $175.44 | $224.91 | $2,361.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.44 / $224.91 / $405.08
| Professional | | $175.44 | $224.91 | $405.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.64 / $68.64 / $234.61
| Professional | | $26.64 | $68.64 | $234.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.49 / $241.13 / $277.16
| Facility | | $228.49 | $241.13 | $277.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $492.24 / $1,110.70 / $1,604.32
| Facility | | $492.24 | $1,110.70 | $1,604.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $198.08 / $284.70 / $535.30
| Professional | | $198.08 | $284.70 | $535.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $486.82 / $1,341.12 / $1,341.12
| Facility | | $486.82 | $1,341.12 | $1,341.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,730.06 / $1,730.06 / $2,091.60
| Professional | | $1,730.06 | $1,730.06 | $2,091.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.74 / $284.10 / $497.97
| Facility | | $215.74 | $284.10 | $497.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.86 / $397.09 / $609.14
| Professional | | $228.86 | $397.09 | $609.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.08 / $249.66 / $311.51
| Professional | | $35.08 | $249.66 | $311.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.11 / $337.14 / $1,215.93
| Facility | | $225.11 | $337.14 | $1,215.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $206.09 / $298.89 / $543.67
| Professional | | $206.09 | $298.89 | $543.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $228.05 / $291.60 / $436.64
| Professional | | $228.05 | $291.60 | $436.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.40 / $228.86 / $326.97
| Professional | | $205.40 | $228.86 | $326.97 |