- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.55 / $783.76 / $1,462.88
| Facility | | $280.55 | $783.76 | $1,462.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.00 / $265.63 / $384.74
| Professional | | $85.00 | $265.63 | $384.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.64 / $414.93 / $986.64
| Facility | | $268.64 | $414.93 | $986.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.71 / $309.25 / $1,167.96
| Professional | | $176.71 | $309.25 | $1,167.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.99 / $826.53 / $1,444.98
| Facility | | $577.99 | $826.53 | $1,444.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $291.57 / $376.74 / $376.74
| Professional | | $291.57 | $376.74 | $376.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.73 / $402.02 / $670.04
| Facility | | $229.73 | $402.02 | $670.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.69 / $294.36 / $767.73
| Professional | | $176.69 | $294.36 | $767.73 |
- 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
- $425.20 / $425.20 / $500.24
| Professional | | $425.20 | $425.20 | $500.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.52 / $294.52 / $957.70
| Professional | | $294.52 | $294.52 | $957.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.78 / $360.29 / $503.46
| Facility | | $346.78 | $360.29 | $503.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.46 / $1,398.97 / $1,398.97
| Facility | | $512.46 | $1,398.97 | $1,398.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.71 / $241.07 / $1,472.60
| Professional | | $176.71 | $241.07 | $1,472.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $176.71 / $241.07 / $608.71
| Professional | | $176.71 | $241.07 | $608.71 |