- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.46 / $213.25 / $1,763.37
| Facility | | $130.46 | $213.25 | $1,763.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.46 / $165.40 / $292.52
| Professional | | $130.46 | $165.40 | $292.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.89 / $435.90 / $718.64
| Facility | | $184.89 | $435.90 | $718.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.96 / $51.02 / $212.65
| Professional | | $31.96 | $51.02 | $212.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.74 / $160.31 / $191.59
| Facility | | $157.74 | $160.31 | $191.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.62 / $664.27 / $1,571.27
| Facility | | $303.62 | $664.27 | $1,571.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.97 / $190.37 / $333.85
| Professional | | $129.97 | $190.37 | $333.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.47 / $1,229.45 / $1,229.45
| Facility | | $333.47 | $1,229.45 | $1,229.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,288.78 / $1,288.78 / $1,450.28
| Professional | | $1,288.78 | $1,288.78 | $1,450.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.46 / $189.66 / $370.30
| Facility | | $130.46 | $189.66 | $370.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.96 / $274.33 / $454.56
| Professional | | $157.96 | $274.33 | $454.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.00 / $222.32 / $830.85
| Facility | | $142.00 | $222.32 | $830.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.27 / $203.99 / $355.03
| Professional | | $134.27 | $203.99 | $355.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.04 / $182.60 / $303.14
| Professional | | $123.04 | $182.60 | $303.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.90 / $157.96 / $225.71
| Professional | | $141.90 | $157.96 | $225.71 |