- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $363.08 / $575.44
| Facility | | $128.82 | $363.08 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $134.90 / $602.56
| Professional | | $109.65 | $134.90 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $190.55 / $794.33
| Facility | | $123.03 | $190.55 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $165.96 / $346.74
| Professional | | $67.61 | $165.96 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $331.13 / $524.81
| Facility | | $263.03 | $331.13 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $173.78
| Professional | | $154.88 | $154.88 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $218.78 / $501.19
| Facility | | $114.82 | $218.78 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.00 / $204.17 / $263.03
| Professional | | $100.00 | $204.17 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $3,630.78 / $9,772.37
| Facility | | $83.18 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.88 / $239.88 / $281.84
| Professional | | $239.88 | $239.88 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $165.96 / $407.38
| Professional | | $165.96 | $165.96 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $190.55 / $794.33
| Facility | | $123.03 | $190.55 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $165.96 / $346.74
| Professional | | $67.61 | $165.96 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $165.96 / $218.78
| Facility | | $83.18 | $165.96 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $112.20 / $331.13
| Professional | | $60.26 | $112.20 | $331.13 |