- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.86 / $572.28 / $990.55
| Facility | | $204.86 | $572.28 | $990.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.79 / $204.86 / $450.00
| Professional | | $188.79 | $204.86 | $450.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.16 / $302.97 / $761.75
| Facility | | $196.16 | $302.97 | $761.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.84 / $244.72 / $924.27
| Professional | | $139.84 | $244.72 | $924.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $422.18 / $603.72 / $1,055.45
| Facility | | $422.18 | $603.72 | $1,055.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.08 / $275.08 / $275.08
| Professional | | $275.08 | $275.08 | $275.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.57 / $318.14 / $530.25
| Facility | | $172.57 | $318.14 | $530.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.88 / $223.82 / $607.15
| Professional | | $139.88 | $223.82 | $607.15 |
- 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
- $336.52 / $336.52 / $395.90
| Professional | | $336.52 | $336.52 | $395.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.07 / $233.07 / $757.88
| Professional | | $233.07 | $233.07 | $757.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.07 / $196.07 / $196.07
| Facility | | $196.07 | $196.07 | $196.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.54 / $1,107.08 / $1,107.08
| Facility | | $405.54 | $1,107.08 | $1,107.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.84 / $176.03 / $1,165.34
| Professional | | $139.84 | $176.03 | $1,165.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.84 / $176.03 / $875.18
| Professional | | $139.84 | $176.03 | $875.18 |