- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.02 / $572.29 / $1,013.67
| Facility | | $199.02 | $572.29 | $1,013.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.43 / $199.02 / $294.26
| Professional | | $188.43 | $199.02 | $294.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.57 / $294.33 / $699.88
| Facility | | $190.57 | $294.33 | $699.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.35 / $219.37 / $828.50
| Professional | | $125.35 | $219.37 | $828.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.15 / $586.51 / $1,025.38
| Facility | | $410.15 | $586.51 | $1,025.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.25 / $267.25 / $267.25
| Professional | | $267.25 | $267.25 | $267.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.96 / $285.18 / $475.30
| Facility | | $162.96 | $285.18 | $475.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.45 / $208.80 / $544.90
| Professional | | $125.45 | $208.80 | $544.90 |
- 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
- $301.51 / $301.51 / $354.72
| Professional | | $301.51 | $301.51 | $354.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.92 / $208.92 / $679.35
| Professional | | $208.92 | $208.92 | $679.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.99 / $245.99 / $255.58
| Facility | | $245.99 | $245.99 | $255.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.52 / $992.37 / $992.37
| Facility | | $363.52 | $992.37 | $992.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.35 / $171.01 / $1,044.59
| Professional | | $125.35 | $171.01 | $1,044.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.03 / $208.92 / $250.70
| Facility | | $188.03 | $208.92 | $250.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.35 / $171.01 / $399.03
| Professional | | $125.35 | $171.01 | $399.03 |