- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.42 / $735.95 / $1,587.23
| Facility | | $248.42 | $735.95 | $1,587.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $211.24 / $248.42 / $340.67
| Professional | | $211.24 | $248.42 | $340.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $237.88 / $367.41 / $873.65
| Facility | | $237.88 | $367.41 | $873.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.47 / $273.83 / $1,034.20
| Professional | | $156.47 | $273.83 | $1,034.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.54 / $731.50 / $1,278.84
| Facility | | $511.54 | $731.50 | $1,278.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.14 / $245.14 / $333.60
| Professional | | $245.14 | $245.14 | $333.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.41 / $355.97 / $593.29
| Facility | | $203.41 | $355.97 | $593.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.56 / $260.64 / $680.22
| Professional | | $156.56 | $260.64 | $680.22 |
- 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
- $376.20 / $376.20 / $442.59
| Professional | | $376.20 | $376.20 | $442.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.79 / $260.79 / $848.02
| Professional | | $260.79 | $260.79 | $848.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.77 / $1,238.75 / $1,238.75
| Facility | | $453.77 | $1,238.75 | $1,238.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.47 / $213.47 / $1,303.95
| Professional | | $156.47 | $213.47 | $1,303.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.98 / $279.79 / $377.85
| Facility | | $252.98 | $279.79 | $377.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.47 / $213.47 / $500.98
| Professional | | $156.47 | $213.47 | $500.98 |