- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.48 / $551.70 / $881.07
| Facility | | $197.48 | $551.70 | $881.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.20 / $186.98 / $270.82
| Professional | | $113.20 | $186.98 | $270.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.10 / $292.06 / $694.49
| Facility | | $189.10 | $292.06 | $694.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.39 / $217.68 / $822.11
| Professional | | $124.39 | $217.68 | $822.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.71 / $581.60 / $1,016.78
| Facility | | $406.71 | $581.60 | $1,016.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $265.19 / $265.19 / $265.19
| Professional | | $265.19 | $265.19 | $265.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.69 / $282.98 / $471.63
| Facility | | $161.69 | $282.98 | $471.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.43 / $207.17 / $540.39
| Professional | | $124.43 | $207.17 | $540.39 |
- 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
- $299.19 / $299.19 / $351.98
| Professional | | $299.19 | $299.19 | $351.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.31 / $207.31 / $674.12
| Professional | | $207.31 | $207.31 | $674.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.10 / $244.10 / $253.62
| Facility | | $244.10 | $244.10 | $253.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.72 / $984.72 / $984.72
| Facility | | $360.72 | $984.72 | $984.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.39 / $169.70 / $1,036.55
| Professional | | $124.39 | $169.70 | $1,036.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.39 / $165.85 / $395.15
| Professional | | $124.39 | $165.85 | $395.15 |