- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.42 / $334.80 / $607.09
| Facility | | $116.42 | $334.80 | $607.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.74 / $110.24 / $209.13
| Professional | | $94.74 | $110.24 | $209.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.49 / $172.20 / $409.44
| Facility | | $111.49 | $172.20 | $409.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.33 / $128.33 / $484.68
| Professional | | $73.33 | $128.33 | $484.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.02 / $343.23 / $600.04
| Facility | | $240.02 | $343.23 | $600.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.89 / $114.89 / $156.34
| Professional | | $114.89 | $114.89 | $156.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.33 / $166.82 / $278.04
| Facility | | $95.33 | $166.82 | $278.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.40 / $122.25 / $318.45
| Professional | | $73.40 | $122.25 | $318.45 |
- 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
- $176.43 / $176.43 / $207.57
| Professional | | $176.43 | $176.43 | $207.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.22 / $122.22 / $397.42
| Professional | | $122.22 | $122.22 | $397.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.10 / $551.71 / $868.11
| Facility | | $256.10 | $551.71 | $868.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.66 / $580.54 / $580.54
| Facility | | $212.66 | $580.54 | $580.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.33 / $100.04 / $611.10
| Professional | | $73.33 | $100.04 | $611.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.33 / $73.33 / $73.33
| Facility | | $73.33 | $73.33 | $73.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.33 / $78.22 / $232.96
| Professional | | $73.33 | $78.22 | $232.96 |