- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.22 / $493.63 / $798.89
| Facility | | $153.22 | $493.63 | $798.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.58 / $145.06 / $252.33
| Professional | | $86.58 | $145.06 | $252.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.57 / $245.42 / $671.98
| Facility | | $158.57 | $245.42 | $671.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.77 / $219.43 / $851.10
| Professional | | $128.77 | $219.43 | $851.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.41 / $488.22 / $853.53
| Facility | | $341.41 | $488.22 | $853.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $205.75 / $205.75 / $205.75
| Professional | | $205.75 | $205.75 | $205.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.50 / $262.26 / $488.25
| Facility | | $139.50 | $262.26 | $488.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.69 / $205.93 / $559.33
| Professional | | $128.69 | $205.93 | $559.33 |
- 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
- $309.92 / $309.92 / $364.61
| Professional | | $309.92 | $309.92 | $364.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $214.62 / $214.62 / $664.66
| Professional | | $214.62 | $214.62 | $664.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.76 / $343.76 / $363.02
| Facility | | $343.76 | $343.76 | $363.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.44 / $1,019.45 / $1,019.45
| Facility | | $373.44 | $1,019.45 | $1,019.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.77 / $131.66 / $1,073.09
| Professional | | $128.77 | $131.66 | $1,073.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.77 / $131.66 / $347.72
| Professional | | $128.77 | $131.66 | $347.72 |