- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.25 / $397.37 / $734.10
| Facility | | $142.25 | $397.37 | $734.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.68 / $142.25 / $203.08
| Professional | | $134.68 | $142.25 | $203.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.21 / $210.38 / $546.86
| Facility | | $136.21 | $210.38 | $546.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.64 / $181.37 / $684.98
| Professional | | $103.64 | $181.37 | $684.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.29 / $419.40 / $733.23
| Facility | | $293.29 | $419.40 | $733.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.02 / $191.02 / $191.02
| Professional | | $191.02 | $191.02 | $191.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.83 / $225.28 / $392.95
| Facility | | $119.83 | $225.28 | $392.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.69 / $165.91 / $450.17
| Professional | | $103.69 | $165.91 | $450.17 |
- 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
- $249.25 / $249.25 / $293.23
| Professional | | $249.25 | $249.25 | $293.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.73 / $172.73 / $556.19
| Professional | | $172.73 | $172.73 | $556.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.11 / $193.11 / $200.64
| Facility | | $193.11 | $193.11 | $200.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.55 / $820.47 / $820.47
| Facility | | $300.55 | $820.47 | $820.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.64 / $122.23 / $863.65
| Professional | | $103.64 | $122.23 | $863.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.64 / $172.73 / $386.92
| Professional | | $103.64 | $172.73 | $386.92 |