- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.82 / $349.03 / $778.15
| Facility | | $117.82 | $349.03 | $778.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.95 / $111.55 / $169.84
| Professional | | $95.95 | $111.55 | $169.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.82 / $174.25 / $414.33
| Facility | | $112.82 | $174.25 | $414.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.20 / $129.86 / $490.47
| Professional | | $74.20 | $129.86 | $490.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.88 / $347.32 / $607.20
| Facility | | $242.88 | $347.32 | $607.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.26 / $116.26 / $158.21
| Professional | | $116.26 | $116.26 | $158.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.47 / $168.82 / $281.37
| Facility | | $96.47 | $168.82 | $281.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.20 / $123.51 / $322.07
| Professional | | $74.20 | $123.51 | $322.07 |
- 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
- $178.30 / $178.30 / $209.76
| Professional | | $178.30 | $178.30 | $209.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.68 / $123.68 / $402.17
| Professional | | $123.68 | $123.68 | $402.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.39 / $621.92 / $1,998.35
| Facility | | $532.39 | $621.92 | $1,998.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.20 / $587.48 / $587.48
| Facility | | $215.20 | $587.48 | $587.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.20 / $101.24 / $618.40
| Professional | | $74.20 | $101.24 | $618.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.31 / $123.68 / $148.41
| Facility | | $111.31 | $123.68 | $148.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.20 / $101.24 / $255.62
| Professional | | $74.20 | $101.24 | $255.62 |