- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.95 / $551.97 / $856.38
| Facility | | $191.95 | $551.97 | $856.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.00 / $181.73 / $283.81
| Professional | | $161.00 | $181.73 | $283.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.80 / $283.88 / $675.02
| Facility | | $183.80 | $283.88 | $675.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.90 / $211.58 / $799.07
| Professional | | $120.90 | $211.58 | $799.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.25 / $565.21 / $988.13
| Facility | | $395.25 | $565.21 | $988.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.76 / $257.76 / $257.76
| Professional | | $257.76 | $257.76 | $257.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.18 / $275.06 / $458.43
| Facility | | $157.18 | $275.06 | $458.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.98 / $201.31 / $525.04
| Professional | | $120.98 | $201.31 | $525.04 |
- 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
- $290.77 / $290.77 / $342.10
| Professional | | $290.77 | $290.77 | $342.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $201.50 / $201.50 / $655.23
| Professional | | $201.50 | $201.50 | $655.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $237.25 / $400.32 / $654.51
| Facility | | $237.25 | $400.32 | $654.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.61 / $957.13 / $957.13
| Facility | | $350.61 | $957.13 | $957.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.90 / $164.94 / $1,007.50
| Professional | | $120.90 | $164.94 | $1,007.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.90 / $164.94 / $384.07
| Professional | | $120.90 | $164.94 | $384.07 |