- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $275.42 / $467.74
| Facility | | $104.71 | $275.42 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $112.20 / $302.00
| Professional | | $81.28 | $112.20 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $173.78 / $426.58
| Facility | | $112.20 | $173.78 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $123.03 / $457.09
| Professional | | $74.13 | $123.03 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $302.00 / $478.63
| Facility | | $239.88 | $302.00 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $114.82 / $120.23
| Professional | | $114.82 | $114.82 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $117.49 / $257.04
| Facility | | $95.50 | $117.49 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $147.91 / $316.23
| Professional | | $72.44 | $147.91 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $3,630.78 / $9,772.37
| Facility | | $79.43 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $177.83 / $208.93
| Professional | | $177.83 | $177.83 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $257.04
| Professional | | $123.03 | $123.03 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $173.78 / $426.58
| Facility | | $112.20 | $173.78 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $123.03 / $457.09
| Professional | | $74.13 | $123.03 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.20 / $123.03 / $181.97
| Facility | | $91.20 | $123.03 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $123.03 / $245.47
| Professional | | $74.13 | $123.03 | $245.47 |