- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $467.74 / $645.65
| Facility | | $144.54 | $467.74 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.04 / $165.96 / $512.86
| Professional | | $138.04 | $165.96 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $169.82 / $524.81
| Facility | | $154.88 | $169.82 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $1,023.29
| Professional | | $123.03 | $123.03 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $257.04 / $416.87
| Facility | | $208.93 | $257.04 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.98 / $194.98 / $194.98
| Professional | | $194.98 | $194.98 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $162.18 / $331.13
| Facility | | $138.04 | $162.18 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $223.87 / $416.87
| Professional | | $109.65 | $223.87 | $416.87 |
- 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
- $302.00 / $302.00 / $354.81
| Professional | | $302.00 | $302.00 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $380.19
| Professional | | $208.93 | $208.93 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $169.82 / $524.81
| Facility | | $154.88 | $169.82 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $123.03 / $1,023.29
| Professional | | $123.03 | $123.03 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $208.93 / $251.19
| Facility | | $123.03 | $208.93 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.03 / $208.93 / $398.11
| Professional | | $123.03 | $208.93 | $398.11 |