- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.86 / $380.67 / $604.14
| Facility | | $115.86 | $380.67 | $604.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.28 / $110.06 / $194.59
| Professional | | $79.28 | $110.06 | $194.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.29 / $189.27 / $518.21
| Facility | | $122.29 | $189.27 | $518.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.31 / $165.92 / $656.35
| Professional | | $99.31 | $165.92 | $656.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.93 / $375.99 / $657.33
| Facility | | $262.93 | $375.99 | $657.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.58 / $155.58 / $155.58
| Professional | | $155.58 | $155.58 | $155.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.58 / $202.25 / $376.53
| Facility | | $107.58 | $202.25 | $376.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.71 / $158.75 / $431.23
| Professional | | $97.71 | $158.75 | $431.23 |
- 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
- $238.98 / $238.98 / $281.14
| Professional | | $238.98 | $238.98 | $281.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.51 / $165.51 / $512.57
| Professional | | $165.51 | $165.51 | $512.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.06 / $163.06 / $192.26
| Facility | | $163.06 | $163.06 | $192.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.99 / $786.17 / $786.17
| Facility | | $287.99 | $786.17 | $786.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.31 / $99.55 / $827.55
| Professional | | $99.31 | $99.55 | $827.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.96 / $165.51 / $198.61
| Facility | | $148.96 | $165.51 | $198.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.31 / $99.55 / $289.94
| Professional | | $99.31 | $99.55 | $289.94 |