- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.09 / $349.07 / $553.16
| Facility | | $106.09 | $349.07 | $553.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.44 / $106.09 / $162.19
| Professional | | $100.44 | $106.09 | $162.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.58 / $156.88 / $407.84
| Facility | | $101.58 | $156.88 | $407.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.45 / $133.80 / $505.34
| Professional | | $76.45 | $133.80 | $505.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.25 / $312.10 / $545.63
| Facility | | $218.25 | $312.10 | $545.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.78 / $119.78 / $142.46
| Professional | | $119.78 | $119.78 | $142.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.36 / $168.00 / $289.91
| Facility | | $89.36 | $168.00 | $289.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.45 / $122.32 / $331.99
| Professional | | $76.45 | $122.32 | $331.99 |
- 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
- $183.90 / $183.90 / $216.35
| Professional | | $183.90 | $183.90 | $216.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.43 / $127.43 / $410.32
| Professional | | $127.43 | $127.43 | $410.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.00 / $542.01 / $1,190.07
| Facility | | $107.00 | $542.01 | $1,190.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.73 / $605.29 / $605.29
| Facility | | $221.73 | $605.29 | $605.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.45 / $91.16 / $637.15
| Professional | | $76.45 | $91.16 | $637.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.45 / $91.16 / $242.89
| Professional | | $76.45 | $91.16 | $242.89 |