- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $199.53 / $257.04
| Facility | | $181.97 | $199.53 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $128.82 / $181.97
| Professional | | $100.00 | $128.82 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $181.97 / $676.08
| Professional | | $117.49 | $181.97 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $398.11 / $630.96
| Facility | | $338.84 | $398.11 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $446.68 / $501.19
| Professional | | $190.55 | $446.68 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $1,096.48 / $1,513.56
| Facility | | $138.04 | $1,096.48 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.47 / $288.40 / $354.81
| Professional | | $245.47 | $288.40 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $181.97 / $1,023.29
| Facility | | $114.82 | $181.97 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $331.13 / $1,778.28
| Professional | | $134.90 | $331.13 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $223.87
| Professional | | $32.36 | $33.11 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $371.54 / $851.14
| Professional | | $204.17 | $371.54 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,230.27 / $1,230.27
| Facility | | $831.76 | $1,230.27 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $1,023.29 / $1,862.09
| Professional | | $177.83 | $1,023.29 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $323.59
| Professional | | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $776.25 / $933.25
| Professional | | $398.11 | $776.25 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,071.52 / $1,412.54
| Facility | | $1,071.52 | $1,071.52 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.83 / $295.12 / $602.56
| Professional | | $131.83 | $295.12 | $602.56 |