- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.12 / $1,236.61 / $2,260.00
| Facility | | $323.12 | $1,236.61 | $2,260.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.86 / $323.12 / $1,236.61
| Professional | | $153.86 | $323.12 | $1,236.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.19 / $391.68 / $948.14
| Facility | | $197.19 | $391.68 | $948.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.93 / $201.61 / $490.41
| Professional | | $76.93 | $201.61 | $490.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.60 / $139.05 / $542.34
| Facility | | $92.60 | $139.05 | $542.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.64 / $103.77 / $1,378.21
| Professional | | $72.64 | $103.77 | $1,378.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.01 / $332.53 / $643.79
| Facility | | $125.01 | $332.53 | $643.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.74 / $129.66 / $527.41
| Professional | | $86.74 | $129.66 | $527.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $192.32 / $211.55 / $259.63
| Professional | | $192.32 | $211.55 | $259.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.09 / $221.17 / $419.26
| Professional | | $173.09 | $221.17 | $419.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.64 / $913.52 / $913.52
| Facility | | $334.64 | $913.52 | $913.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $961.60 / $961.60 / $1,442.40
| Professional | | $961.60 | $961.60 | $1,442.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.62 / $134.62 / $134.62
| Professional | | $134.62 | $134.62 | $134.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.86 / $250.02 / $552.66
| Facility | | $153.86 | $250.02 | $552.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $109.09 / $211.55 / $384.64
| Professional | | $109.09 | $211.55 | $384.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $675.04 / $675.04 / $675.04
| Professional | | $675.04 | $675.04 | $675.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $153.86 / $196.17 / $326.94
| Professional | | $153.86 | $196.17 | $326.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.77 / $84.62 / $398.93
| Professional | | $80.77 | $84.62 | $398.93 |