- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.19 / $449.14 / $814.41
| Facility | | $156.19 | $449.14 | $814.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.31 / $147.88 / $225.16
| Professional | | $97.31 | $147.88 | $225.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.56 / $231.00 / $549.27
| Facility | | $149.56 | $231.00 | $549.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.38 / $172.16 / $650.20
| Professional | | $98.38 | $172.16 | $650.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $321.93 / $460.36 / $804.83
| Facility | | $321.93 | $460.36 | $804.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $209.74 / $209.74 / $209.74
| Professional | | $209.74 | $209.74 | $209.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.88 / $223.80 / $373.00
| Facility | | $127.88 | $223.80 | $373.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.41 / $164.06 / $427.62
| Professional | | $98.41 | $164.06 | $427.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.43 / $4,618.00 / $9,239.00
| Facility | | $83.43 | $4,618.00 | $9,239.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.64 / $236.64 / $278.39
| Professional | | $236.64 | $236.64 | $278.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.96 / $163.96 / $533.16
| Professional | | $163.96 | $163.96 | $533.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.06 / $216.74 / $379.29
| Facility | | $193.06 | $216.74 | $379.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.29 / $778.81 / $778.81
| Facility | | $285.29 | $778.81 | $778.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.38 / $134.21 / $819.80
| Professional | | $98.38 | $134.21 | $819.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.38 / $134.21 / $313.17
| Professional | | $98.38 | $134.21 | $313.17 |