- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $457.09 / $851.14
| Facility | | $141.25 | $457.09 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.90 / $162.18 / $501.19
| Professional | | $134.90 | $162.18 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $229.09 / $691.83
| Facility | | $147.91 | $229.09 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $204.17 / $758.58
| Professional | | $120.23 | $204.17 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $398.11 / $645.65
| Facility | | $323.59 | $398.11 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.55 / $190.55 / $190.55
| Professional | | $190.55 | $190.55 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $186.21 / $398.11
| Facility | | $131.83 | $186.21 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.65 / $245.47 / $501.19
| Professional | | $109.65 | $245.47 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $3,630.78 / $9,772.37
| Facility | | $83.18 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $346.74
| Professional | | $295.12 | $295.12 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $426.58
| Professional | | $204.17 | $204.17 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $229.09 / $691.83
| Facility | | $147.91 | $229.09 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $204.17 / $758.58
| Professional | | $120.23 | $204.17 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $204.17 / $245.47
| Facility | | $120.23 | $204.17 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $190.55 / $389.05
| Professional | | $120.23 | $190.55 | $389.05 |