- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.37 / $385.49 / $630.74
| Facility | | $141.37 | $385.49 | $630.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.85 / $141.37 / $253.95
| Professional | | $133.85 | $141.37 | $253.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.37 / $258.23 / $704.95
| Facility | | $135.37 | $258.23 | $704.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.23 / $148.41 / $361.50
| Professional | | $71.23 | $148.41 | $361.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.32 / $416.13 / $727.50
| Facility | | $261.32 | $416.13 | $727.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.51 / $139.51 / $189.84
| Professional | | $139.51 | $139.51 | $189.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.70 / $218.99 / $503.66
| Facility | | $103.70 | $218.99 | $503.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.30 / $164.13 / $244.06
| Professional | | $89.30 | $164.13 | $244.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $3,472.00 / $9,239.00
| Facility | | $83.43 | $3,472.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.24 / $214.24 / $252.05
| Professional | | $214.24 | $214.24 | $252.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.41 / $205.70 / $552.41
| Professional | | $148.41 | $205.70 | $552.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.23 / $704.95 / $704.95
| Facility | | $258.23 | $704.95 | $704.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.40 / $89.05 / $313.26
| Professional | | $29.40 | $89.05 | $313.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.57 / $148.41 / $178.09
| Facility | | $133.57 | $148.41 | $178.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.40 / $89.05 / $588.54
| Professional | | $29.40 | $89.05 | $588.54 |