- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $446.68 / $1,412.54
| Facility | | $134.90 | $446.68 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $158.49 / $478.63
| Professional | | $128.82 | $158.49 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $218.78 / $660.69
| Facility | | $141.25 | $218.78 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $194.98 / $724.44
| Professional | | $114.82 | $194.98 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $380.19 / $616.60
| Facility | | $309.03 | $380.19 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $181.97
| Professional | | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $177.83 / $380.19
| Facility | | $125.89 | $177.83 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $234.42 / $478.63
| Professional | | $104.71 | $234.42 | $478.63 |
- 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
- $281.84 / $281.84 / $331.13
| Professional | | $281.84 | $281.84 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $194.98 / $407.38
| Professional | | $194.98 | $194.98 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $190.55
| Facility | | $190.55 | $190.55 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $218.78 / $660.69
| Facility | | $141.25 | $218.78 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $194.98 / $724.44
| Professional | | $114.82 | $194.98 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $194.98 / $234.42
| Facility | | $114.82 | $194.98 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.82 / $194.98 / $371.54
| Professional | | $114.82 | $194.98 | $371.54 |