- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.17 / $520.62 / $914.28
| Facility | | $61.17 | $520.62 | $914.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.91 / $66.20 / $352.71
| Professional | | $57.91 | $66.20 | $352.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.66 / $321.82 / $918.60
| Facility | | $221.66 | $321.82 | $918.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.60 / $264.56 / $1,189.69
| Professional | | $87.60 | $264.56 | $1,189.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.60 / $681.54 / $1,191.50
| Facility | | $476.60 | $681.54 | $1,191.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.14 / $82.14 / $82.14
| Professional | | $82.14 | $82.14 | $82.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71.55 / $234.00 / $682.50
| Facility | | $71.55 | $234.00 | $682.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $159.19 / $287.91 / $782.16
| Professional | | $159.19 | $287.91 | $782.16 |
- 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
- $432.67 / $432.67 / $509.02
| Professional | | $432.67 | $432.67 | $509.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $300.00 / $300.00 / $929.07
| Professional | | $300.00 | $300.00 | $929.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.00 / $1,425.00 / $1,425.00
| Facility | | $522.00 | $1,425.00 | $1,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.56 / $180.00 / $1,500.00
| Professional | | $52.56 | $180.00 | $1,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.00 / $300.00 / $360.00
| Facility | | $270.00 | $300.00 | $360.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.56 / $180.00 / $535.82
| Professional | | $52.56 | $180.00 | $535.82 |