- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.09 / $854.32 / $1,260.33
| Facility | | $244.09 | $854.32 | $1,260.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.81 / $244.09 / $1,937.68
| Professional | | $180.81 | $244.09 | $1,937.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.83 / $1,386.96 / $8,459.92
| Facility | | $1,040.83 | $1,386.96 | $8,459.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.05 / $235.05 / $235.05
| Professional | | $235.05 | $235.05 | $235.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.98 / $445.02 / $999.68
| Facility | | $285.98 | $445.02 | $999.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $158.72 / $321.74 / $681.33
| Professional | | $158.72 | $321.74 | $681.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.31 / $406.82 / $572.57
| Professional | | $179.31 | $406.82 | $572.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.14 / $854.32 / $1,244.58
| Facility | | $256.14 | $854.32 | $1,244.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.92 / $256.14 / $1,244.58
| Professional | | $204.92 | $256.14 | $1,244.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $446.00 / $452.02 / $602.70
| Professional | | $446.00 | $452.02 | $602.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $293.44 / $501.35 / $999.68
| Facility | | $293.44 | $501.35 | $999.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.90 / $322.48 / $967.43
| Professional | | $195.90 | $322.48 | $967.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.35 / $301.35 / $331.49
| Facility | | $301.35 | $301.35 | $331.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.35 / $301.35 / $331.49
| Professional | | $301.35 | $301.35 | $331.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.57 / $180.81 / $402.36
| Professional | | $126.57 | $180.81 | $402.36 |