- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $676.08 / $2,187.76
| Facility | | $208.93 | $676.08 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $239.88 / $741.31
| Professional | | $194.98 | $239.88 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $338.84 / $1,023.29
| Facility | | $218.78 | $338.84 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $295.12 / $1,122.02
| Professional | | $177.83 | $295.12 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $588.84 / $933.25
| Facility | | $467.74 | $588.84 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $288.40
| Professional | | $275.42 | $275.42 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $269.15 / $575.44
| Facility | | $190.55 | $269.15 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $354.81 / $741.31
| Professional | | $162.18 | $354.81 | $741.31 |
- 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
- $426.58 / $426.58 / $501.19
| Professional | | $426.58 | $426.58 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $630.96
| Professional | | $295.12 | $295.12 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $288.40 / $288.40
| Facility | | $288.40 | $288.40 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $338.84 / $1,023.29
| Facility | | $218.78 | $338.84 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $295.12 / $1,122.02
| Professional | | $177.83 | $295.12 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $295.12 / $354.81
| Facility | | $177.83 | $295.12 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.83 / $295.12 / $562.34
| Professional | | $177.83 | $295.12 | $562.34 |