- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.90 / $363.22 / $1,017.89
| Facility | | $138.90 | $363.22 | $1,017.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.09 / $145.12 / $248.77
| Professional | | $116.09 | $145.12 | $248.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.97 / $659.25 / $1,094.59
| Facility | | $225.97 | $659.25 | $1,094.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.87 / $114.02 / $217.68
| Professional | | $109.87 | $114.02 | $217.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $207.31 / $207.31
| Facility | | $80.00 | $207.31 | $207.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.75 / $486.54 / $924.02
| Facility | | $134.75 | $486.54 | $924.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.16 / $119.76 / $326.35
| Professional | | $95.16 | $119.76 | $326.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.70 / $984.72 / $984.72
| Facility | | $331.70 | $984.72 | $984.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,032.40 / $1,032.40 / $1,554.83
| Professional | | $1,032.40 | $1,032.40 | $1,554.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.46 / $207.31 / $331.70
| Facility | | $126.46 | $207.31 | $331.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.31 / $207.31 / $259.14
| Professional | | $207.31 | $207.31 | $259.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.75 / $248.77 / $466.45
| Professional | | $134.75 | $248.77 | $466.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.82 / $213.44 / $746.56
| Facility | | $138.82 | $213.44 | $746.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.08 / $195.94 / $324.95
| Professional | | $98.08 | $195.94 | $324.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.07 / $207.31 / $248.77
| Facility | | $87.07 | $207.31 | $248.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.07 / $87.07 / $132.68
| Professional | | $87.07 | $87.07 | $132.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.84 / $207.31 / $279.87
| Professional | | $80.84 | $207.31 | $279.87 |