- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $478.63 / $812.83
| Facility | | $173.78 | $478.63 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $234.42 / $691.83
| Professional | | $173.78 | $234.42 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $794.33 / $1,318.26
| Facility | | $302.00 | $794.33 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $275.42 / $912.01
| Professional | | $165.96 | $275.42 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $549.54 / $794.33
| Facility | | $436.52 | $549.54 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $117.49 / $269.15
| Professional | | $117.49 | $117.49 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $338.84 / $537.03
| Facility | | $177.83 | $338.84 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $288.40 / $724.44
| Professional | | $165.96 | $288.40 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $4,897.79 / $9,772.37
| Facility | | $83.18 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $467.74
| Professional | | $398.11 | $398.11 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.42 / $275.42 / $457.09
| Professional | | $275.42 | $275.42 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $134.90 / $134.90
| Facility | | $134.90 | $134.90 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $794.33 / $1,318.26
| Facility | | $302.00 | $794.33 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $275.42 / $912.01
| Professional | | $165.96 | $275.42 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $275.42 / $331.13
| Facility | | $165.96 | $275.42 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $218.78 / $489.78
| Professional | | $165.96 | $218.78 | $489.78 |