- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.87 / $169.41 / $1,839.06
| Facility | | $131.87 | $169.41 | $1,839.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.87 / $169.41 / $318.16
| Professional | | $131.87 | $169.41 | $318.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.16 / $478.73 / $789.35
| Facility | | $199.16 | $478.73 | $789.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.68 / $144.50 / $219.17
| Professional | | $29.68 | $144.50 | $219.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.43 / $182.32 / $207.73
| Facility | | $179.43 | $182.32 | $207.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.38 / $811.77 / $1,571.27
| Facility | | $362.38 | $811.77 | $1,571.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.78 / $213.33 / $409.60
| Professional | | $155.78 | $213.33 | $409.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.61 / $1,229.45 / $1,229.45
| Facility | | $382.61 | $1,229.45 | $1,229.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,301.77 / $1,301.77 / $1,644.08
| Professional | | $1,301.77 | $1,301.77 | $1,644.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.75 / $224.45 / $374.30
| Facility | | $179.75 | $224.45 | $374.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.75 / $311.69 / $459.14
| Professional | | $179.75 | $311.69 | $459.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.57 / $261.37 / $943.26
| Facility | | $183.57 | $261.37 | $943.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.79 / $220.45 / $415.59
| Professional | | $163.79 | $220.45 | $415.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.12 / $716.53 / $866.23
| Facility | | $377.12 | $716.53 | $866.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.30 / $217.16 / $328.05
| Professional | | $163.30 | $217.16 | $328.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.22 / $179.75 / $256.47
| Professional | | $161.22 | $179.75 | $256.47 |